Medical Claims Investigator Claritev CorpMedical Claims InvestigatorNaperville, IL$50,000–$55,000 / yearThe incumbent will employ data mining and coordination of benefit techniques to analyze and audit hospital and physician claims to identify errant claim payments. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.
SIU Investigator Allied UniversalSIU InvestigatorChicago, Illinois$27–$32 / hourFull timeAcquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance . High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud .
MRSGM NA Logistics Claims Manager - First Party Munchener Ruckversicherungs-Gesellschaft Aktiengesellschaft (Munich Re)MRSGM NA Logistics Claims Manager - First PartySchaumburg, ILWe are in search of an experienced insurance professional responsible for investigating, evaluating, and settling complex cargo damage claims by examining policies, gathering evidence, analyzing loss details, negotiating settlements with involved parties, and ensuring compliance with company guidelines, often handling high-value or intricate claims with a focus on minimizing losses; requiring strong knowledge of cargo insurance policies, shipping regulations, and claims handling procedures. Complex Claim Management - Leading the handling of large or complex cargo claims involving multiple parties, legal disputes, or significant financial exposure.
Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)IL$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Surveillance Investigator Allied UniversalSurveillance InvestigatorMerrillville, INThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. RESPONSIBILITIES: Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability.
Senior Fraud and Waste Investigator, Medicaid Humana IncSenior Fraud and Waste Investigator, MedicaidILRemote$71,100–$97,800 / yearThe Senior Fraud and Waste Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Make decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
(Remote) Sr. Special Investigator Efinancial LLC(Remote) Sr. Special InvestigatorDes Plaines, ILRemote$91,545–$118,470 / yearProven ability to independently plan and conduct structured investigative interviews, including complex or adversarial interviews, with strong written communication skills and a demonstrated track record of producing investigative reports and case summaries used in regulatory or legal proceedings. Draft clear, concise, and well-supported fraud case summaries and investigative reports for SIU leadership, legal counsel, and compliance teams as well as reports to state departments of insurance and national fraud databases within required timeframes.
Investigator I ArcBest CorpInvestigator IChicago, ILOur technology and innovations team, ArcBest Technologies, provides custom-built solutions, leading-edge technology, and advanced analytics that help support our customers and optimize supply chains. Provide Company responses to unemployment processes: gather and provide responses to unemployment claims, respond to state determinations, and prepare employees or outside representatives with defense statements for unemployment claims hearings.
Affirmative Civil Enforcement ACE Investigator Contact Government Services LLCAffirmative Civil Enforcement ACE InvestigatorChicago, ILPerforms 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.
NewSurveillance Investigator The Robison GroupSurveillance InvestigatorSchaumburg, ILThrough our operating brands, HVACi, StrikeCheck, National Fire Experts, Donan Engineering, BSC Forensics, Component Testing Laboratories, The Robison Group, VRC Investigations, TechLoss, Mecanica Scientific Services, and HMI we are respected as the industry leader for our scale and our track record of conducting expert, specialized, and accurate investigations. Individuals selected for the position will be expected to perform investigations of workers compensation claims, liability investigations, multi-line insurance claims, criminal and civil background checks, and other investigative tasks.
Affirmative Civil Enforcement (ACE) Investigator Contact Government Services LLCAffirmative Civil Enforcement (ACE) InvestigatorHammond, IN$60,000–$100,000 / yearUtilizes electronic databases (e.g., CLEAR/Accurint, LexisNexis, PACER, SAM.gov, USASpending.gov) to identify and locate witnesses and subjects, verify corporate structure and ownership, and develop documentary evidence to support investigations. For the past nine years we've been growing our government-contracting portfolio, and along the way we've created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work.
Investigator II Elevance Health IncInvestigator IIChicago, IL$78,320–$128,160 / yearWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.
Surveillance Investigator VRC InvestigationsSurveillance InvestigatorChicago, IllinoisVRC provides their investigators with necessary equipment and comparable pay, to include drive time, above normal commute mileage reimbursement, company paid licensing fees in most states and allowance for non-reimbursed business expenses. We currently have career opportunities for experienced, self-determined, and highly motivated SURVEILLANCE INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud.
General Liability Claim Representative The Travelers Companies IncGeneral Liability Claim RepresentativeDowners Grove, IL$67,000–$110,600 / yearInvestigates each claim through prompt contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
General Liability Claim Representative TravelersGeneral Liability Claim RepresentativeChicago, IllinoisInvestigates each claim through prompt contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Intel Analyst Allied UniversalIntel AnalystChicago, ILAllied Universal SkillBridge Program Allied Universal partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits. Dog Detection Spotlight - Kyle and Maverick As part of Allied Universal Enhanced Protection Services' fleet of detection canine teams, Kyle and Maverick are trained and certified to screen cargo under the U.S. Transportation Security Administration's (TSA) Third-Party Canine (3PK9) Program.
Janitor - Part Time Allied UniversalJanitor - Part TimeLombard, ILDamp wipe and buff all glass furnishings Clean entry door glass indoors and outer surface Remove all stains from vertical surfaces such as doors, door frames, and around light switches, private entry glass and dividers Wash, clean and sterilize all water coolers Sweep private stairways, and vacuum if carpeted Clean building floors, by sweeping and mopping Clean and sanitize, and restock supplies in bathrooms QUALIFICATIONS: Must be able to follow written and oral directions Minimum of 6 months of experience in a janitorial type position. Read More Allied Universal SkillBridge Program Allied Universal partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits.
Janitor Allied UniversalJanitorChicago, ILAllied Universal SkillBridge Program Allied Universal® partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits. Dog Detection Spotlight - Kyle and Maverick As part of Allied Universal Enhanced Protection Services fleet of detection canine teams, Kyle and Maverick are trained and certified to screen cargo under the U.S. Transportation Security Administrations (TSA) Third-Party Canine (3PK9) Program.
Litigation Specialist Warrior Insurance NetworkLitigation SpecialistBedford Park, ILRemote$75,000–$100,000 / yearFull timeConduct 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. Are you an experienced Litigation Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? .
Catastrophe Field Property Adjuster- Chicago Area Allstate Insurance CompanyCatastrophe Field Property Adjuster- Chicago AreaChicago, IL$56,000–$105,000 / yearYou'll wear a few hats that will require a level of experience: The Customer Service Expert -you'll live into Allstate's Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each Property claim. We're hosting onsite interviews on the week of August 17th in our Chicago Suburban office, offering you the chance to meet our hiring team in person and discover how you can join Allstate's trusted catastrophe claims team.
Property Adjuster Inside Trainee Hybrid Northbrook, IL Allstate Insurance CompanyProperty Adjuster Inside Trainee Hybrid Northbrook, ILNorthbrook, IL$47,500–$83,755 / yearActive Listening, Business Communications, Communication, Critical Thinking, Customer Service, Empathy, Fraud Investigations, Information Collection, Timeline Management, Time Management, Working Independently. You'll wear a few hats that will require a level of experience: The Customer Service Expert -you'll live into Allstate's Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each Property claim.
NewLarge Loss Contents Property Adjuster - Chicagoland, IL Allstate Insurance CompanyLarge Loss Contents Property Adjuster - Chicagoland, ILChicago, IL$68,000–$117,700 / yearYou'll wear a few hats that will require a level of experience: The Customer Service Expert -you'll live into Allstate's Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each Property claim. Active Listening, Communication, Critical Thinking, Customer Service, Empathy, Mitigation, Multitasking, Property Adjusting, Time Management, Working Independently, Xactimate (Estimating Software).
Litigation Specialist First Chicago Insurance Company (FCIC)Litigation SpecialistBedford Park, ILRemote$75,000–$100,000 / yearFull timeConduct 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.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)IL$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Virtual Triage Obvious Total Loss Adjuster Allstate Insurance CompanyVirtual Triage Obvious Total Loss AdjusterIL$53,500–$84,625 / yearThis role conducts virtual inspections of vehicle damage-including automobiles, motorcycles, ATVs, and RVs-prepares repair estimates, completes total loss valuations, and negotiates moderately complex (and occasionally more complex) settlements with repair facilities, tow yards, and customers. This role offers a sign on bonus of $1,000 if you have an active appraiser license or active adjuster license in TX, FL, or your resident state (current employees and candidates who have previously worked for and are seeking to be rehired at Allstate and its family of companies are not eligible for this sign-on bonus).
Litigation Specialist First Chicago Insurance CompanyLitigation SpecialistILRemote$75,000–$100,000 / yearConduct 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.
Manager Special Investigations Health Care Service CorpManager Special InvestigationsChicago, IL$92,700–$167,500 / yearJOB REQUIREMENTS: Bachelor's Degree in Criminal Justice, Finance or Accounting or related field and 5 years of direct law enforcement/investigation experience, including supervision of cases and investigators OR 9 years of direct professional work experience in the detection, investigation and/or prosecution of complex health care fraud schemes with the following professional certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), and/or Certified Fraud Examiner (CFE). This position will be responsible for managing healthcare fraud and internal fraud investigations initially focusing on IL Medicaid; managing and training investigators as well as support staff; establishing and maintaining liaison with healthcare providers and law enforcement; and coordinating anti-fraud activities with other departments at HCSC.
Bodily Injury Adjuster - Represented/Litigation, Moderate (IL/WI) Remote Allstate Insurance CompanyBodily Injury Adjuster - Represented/Litigation, Moderate (IL/WI) RemoteILRemote$53,500–$84,625 / yearYou'll wear a few hats to fill a few roles throughout your day that all require a level of experience: The Customer Service Expert -you'll live into Allstate's Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each casualty claim. Bodily Injury Claims, Business Communications, Claims Evaluation, Critical Thinking, Fraud Investigations, Information Collection, Legal Negotiations, Liability Analysis, Problem Solving, Time Management.
Bodily Injury Adjuster - Represented, Complex/Severe (IL, WI) Remote Allstate Insurance CompanyBodily Injury Adjuster - Represented, Complex/Severe (IL, WI) RemoteILRemote$53,500–$84,625 / yearYou'll wear a few hats to fill a few roles throughout your day that all require a level of experience: The Customer Service Expert -you'll live into Allstate's Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each casualty claim. The Problem Solver -you'll utilize multiple tools to get the job done in a fast-paced environment, including estimate tools, job aids, and additional settlement platforms, all while using your sharp critical thinking skills.
NewSenior Manager Special Investigations Health Care Service CorpSenior Manager Special InvestigationsChicago, IL$92,700–$167,500 / yearLead the design, implementation, and ongoing optimization of pre-payment review process to identify and prevent fraudulent, wasteful, abusive, or non-compliant claims prior to payment and oversee, monitor and make decisions regarding pre-payment review status of providers. This position is responsible for managing health care fraud and internal fraud investigations; managing and training investigators and support staff; establishing and maintaining liaison with health care providers and law enforcement; and coordinating anti-fraud activities with other departments at HCSC.