11 Results for

Claims Investigator Jobs in Clearing, IL

Jobs

Chicago, IL30+ days ago

$57,000–$83,000 Per Year

An Associates or Bachelors degree in Criminal Justice or a related field, or five years of insurance claims investigation experience or five years of professional investigation experience with law enforcement agencies, or seven years of professional investigative experience involving economic or insurance fraud related matters. The Investigator will work collaboratively with the Claims Department and Legal to quickly identify and combat potential fraud in a business environment that values speed and service, allowing us to quickly process and pay legitimate claims for our policyholders.

Chicago, IL30+ days ago

$89,508–$138,370 Per Year

Specialized Experience for the GS-12 level: One year of specialized experience equivalent to the GS-11 grade level or equivalent public or private sector experience that has equipped you with the particular knowledge, skills, and abilities to perform successfully the following duties or work assignments below: Conducting the full range of criminal investigations of greater than average complexity and importance using accepted methodology and problem-solving techniques. If you are claiming eligibility under the Veterans Employment Opportunities Act (VEOA), you must submit: A copy of your DD-214 that shows active service and character of discharge (member copy 4, Separated Members only) OR a certification of expected discharge or release from active duty under honorable conditions within 120 days from the date of application (Current Active Duty Members only).

Chicago, IL30+ days ago

$57,188–$97,087 Per Year

Grade-point average (G.P.A) -- Applicants must have a grade-point average of 3.0 or higher out of a possible 4.0 (B or better) as recorded on their official transcript or as computed based on 4 years of education or as computed based on courses completed during the final 2 years of the curriculum; OR 3.5 or higher out of a possible 4.0 (B or better) based on the average of the required courses completed in the major field or the required courses in the major field completed during the final 2 years of the curriculum. #### Specialized Experience for the GS-11 level One year of specialized experience equivalent to the GL/GS-9 grade level or equivalent public or private sector experience that has equipped you with the particular knowledge, skills, and abilities to perform successfully the following three (3) duties or work assignments below: Experience conducting the full range of criminal investigations of average complexity and importance using accepted methodology and problem-solving techniques.

Chicago, IL30+ days ago

Performs sophisticated analyses of large-scale hard-copy and electronic data such as health care claims data, financial transaction data, accounting records, or bank records to develop investigative leads and to determine their potential relevance to the allegations at issue. • Performs analysis to clarify the target suspects or organizations pattern of operations to identify information relevant to the legal issues involved and to recommend valuable approaches to the AUSAs or other members of the investigative team.

Hammond, IN23 days ago

The ACE Investigator will support Assistant United States Attorneys (AUSAs) in the investigation and development of complex civil fraud matters involving healthcare fraud, procurement fraud, grant fraud, and abuse of federal programs and funds. Utilize electronic databases and investigative tools including CLEAR/Accurint, LexisNexis, PACER, SAM.gov, and USASpending.gov to identify witnesses, subjects, and corporate relationships.

Merrillville, Indiana9 days ago

Chicago, IL30+ days ago

$85,000–$105,000 Per Year

Communication skills, Ability to interact professionally and effectively with all levels of staff, including AUSAs, support staff, client agencies, debtors, debtor attorneys, and their staff, court personnel, business executives, witnesses, and the public. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently accurately and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client.

Chicago, IL30+ days ago

$107,114.45–$141,560.16 Per Year

Establishes and verifies relationships among all facts and evidence obtained or presented to confirm the authenticity of documents, corroborate witness statements, and otherwise build proof necessary to successful case resolution. • Establishes and/or verifies relationships among all facts and evidence obtained or presented to confirm the authenticity of documents, corroborate witness statements, and otherwise build proof necessary for successful litigation.

New!

Bedford Park, IL2 days ago

Remote

$75,000–$100,000 Per Year

Conduct prompt investigations by securing statements from the involved parties/witnesses and obtaining all necessary documents, including but not limited to, police reports, medical specials, photographs, and/or appraisals. Ability to research and interpret case law, statute, and coverage forms in order to properly adjust and conclude claims.

Chicago, IL30+ days ago

$80,000–$150,000 Per Year

Analyze and calculate ability to pay settlements and judgments, including analyzing debt covenants, borrowing capacity, adjusted earnings, and earnings per share financial ratios, accounts receivable, and accounts payable aging schedules, tax considerations, assessing collectability, and developing payment terms and schedules. CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-pay analyses, which serve a significant role in determinations regarding investigations, prosecutions, settlements, and recovery in these matters, which can be voluminous and complex.

Chicago, IL30+ days ago

Remote

Full-time

Technical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.

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Claims Investigator Jobs in Clearing, IL

SIU Investigator Chubb Ltd

Criminal Investigator, GS-1811-12/13 (MP) U.S. Department of Education

Criminal Investigator (Open Continuous) U.S. Department of Education

Affirmative Civil Enforcement ACE Investigator Contact Government Services LLC

Affirmative Civil Enforcement (ACE) Investigator SGI Global, LLC

Surveillance Investigator Allied Universal

Healthcare Fraud Investigator Contact Government Services LLC

Senior Financial Investigator Contact Government Services LLC

Litigation Specialist First Chicago Insurance Company (FCIC)

Senior Auditor Contact Government Services LLC

Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare Alliance

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