Investigator Ethos Risk ServicesInvestigatorSpringfield, MOPart timeCONDITIONS:While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be requiredMost surveillance cases start at 6:00AM. REQUIREMENTS:Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports.
Entry-Level Investigator Ethos Risk ServicesEntry-Level InvestigatorSt. Louis, MOFull timeOur Full-Time Entry-Level Field Investigator position will help launch your career by providing you with an industry leading FULLY PAID Investigator Training Program - no prior experience necessary! Documentation: Finalize case files by submitting case reports and uploading video footage via personal laptop at the end of the day.
Surveillance Investigator - Part Time Allied UniversalSurveillance Investigator - Part TimeSt Louis, MO$20–$25 / hourThe 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.
Surveillance Investigator Allied UniversalSurveillance InvestigatorSt Louis, MOThe 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.
NewSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)MO$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
SIU Investigator Centene Corporation GroupSIU InvestigatorMO$56,200–$101,000 / yearLicenses/Certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or other related investigative, auditing, or compliance certification preferred. Collaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts.
SIU Clinical Investigator Healthcare Fraud ShieldSIU Clinical InvestigatorChesterfield, MissouriRemoteWork with SIU Team (Clinical Reviewers, CPCs, Investigators, Analysts-including performing quality check on work, assisting in research, discuss to make appropriate coding determinations as needed). Healthcare Fraud Shield, a leader in healthcare fraud prevention and payment integrity solutions, is looking for a talented Clinical Coder/Fraud Investigator to join our team.
Investigator - Medicaid Fraud Control Unit Missouri Attorney GeneralInvestigator - Medicaid Fraud Control UnitJefferson City, MO$51,000–$55,000 / yearFull timeThe Investigator's primary duties include conducting interviews, obtaining and analyzing Medicaid claims, reviewing healthcare provider documentation, preparing detailed investigative reports and exhibits, maintaining investigative case files, testifying in court, interfacing with other law enforcement and government agencies, collecting and analyzing evidence, conducting interviews, preparing reports and exhibits to include testimony in courts, and collecting evidence for possible use in civil or criminal proceedings. The MFCU utilizes a team-based approach to uncover abuse and neglect of Medicaid recipients and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, physicians, dentists, nurses, and other Medicaid providers.
Clinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthRemote-MO, MORemote$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred.
Tax Law Specialist Tax Exempt Bond Specialist Department of the Treasury, USTax Law Specialist Tax Exempt Bond SpecialistChesterfield, MO$125,776–$192,694 / yearPerforming analytical services related to the structuring of municipal financings including tax advantaged bonds and other financial products beyond traditional tax advantaged bonds including: Short-Term Debt and Cash Flow Management which include Tax Anticipation Notes, Revenue Anticipation Notes, Bond Anticipation Notes, and Commercial Paper. When assigned to the TEB Voluntary Closing Agreement Program, the incumbent confers with customers and representatives to explain financial, legal and other significant issues involved and the applicability of pertinent tax laws, regulations, and related filing requirements and explains corrective actions required or adjustments to promote future compliance.