13 Results for

Claims Investigator Jobs in New Jersey

Jobs

Investigator Ethos Risk Services

Toms River, NJ

Full time
Quick Apply

CONDITIONS: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.

30+ days ago

Entry-Level Investigator Ethos Risk Services

Atlantic City, NJ

Full time
Quick Apply

Our 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 file by submitting case reports and uploading video footage via personal laptop at the end of the day.

30+ days ago

Associate SIU Investigator The Travelers Companies Inc

Morristown, NJ

$57,900–$95,600 / year

Provide strong customer service by maintaining contact with business partners, customers and external resources throughout the life of each investigation, including liaison network with claim, legal, underwriting partners, public officials, law enforcement officers and others to obtain assistance in conducting investigations. 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.

14 days ago

Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

$46,988–$102,000 / year

Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple perpetrators or intricate healthcare fraud schemes. Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings.

7 days ago

SIU Investigator Centene Corporation Group

$56,200–$101,000 / year

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. 2+ years Fraud, waste, and abuse investigations, healthcare investigations, claims audits, payment integrity, healthcare compliance, law enforcement investigations, or a related investigative field required.

30+ days ago

Asset Protection Investigator Saks Global Enterprises LLC

Paramus, NJ

$21.53–$26.91 / hour

Its 12 stores serve primarily as a selling channel for residual inventory from Neiman Marcus, Saks Fifth Avenue and Bergdorf Goodman, offering a compelling assortment of high-end designers and everyday favorites at the best prices. Achieve targets of investigative performance by identifying and addressing internal and external theft exposures; complete accident investigations and general liability claims reports.

15 days ago

Investigator II Horizon Healthcare Services

Newark, New Jersey

This position is accountable for analytical and investigative activities (external and internal) related to claims, enrollment, accounting and other operations to detect, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct. $63,000 - $84,420 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.

9 days ago

Investigator II Blue Cross and Blue Shield Association

Newark, NJ

$63,000–$84,420 / year

This position is accountable for analytical and investigative activities (external and internal) related to claims, enrollment, accounting and other operations to detect, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct. This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.

8 days ago

CPC Investigator Horizon Healthcare Services

Newark, New Jersey

The Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. $70,500 - $94,395 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.

8 days ago

CPC Investigator Blue Cross and Blue Shield Association

Newark, NJ

$70,500–$94,395 / year

The Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. The incumbent will also be responsible for handling low level investigative activities (external) related to claims, enrollment, accounting, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct.

30+ days ago

Surveillance Investigator VRC Investigations

Toms River, New Jersey

VRC 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.

7 days ago

Manager, Business Compliance Requests for Information (RFI) CVS Health Corp

$66,330–$145,860 / year

The RFI Manager within the Payment Integrity Center of Excellence (PI COE) leads the team responsible for managing and responding to official requests for information from regulatory agencies, state departments, law enforcement, and internal stakeholders. The manager oversees the full lifecycle of each request, from intake and triage through coordination, review, and final delivery, with a strong focus on meeting turnaround time commitments and maintaining accountability across all RFI-related activities.

8 days ago

Large Loss Property Adjuster - Field Estimating - New Brunswick, NJ Allstate Insurance Company

New Brunswick, NJ

$68,500–$115,600 / year

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 claim. Active Listening, Case Management, Claims Administration, Communication, Critical Thinking, Customer Service, Empathy, Insurance Administration, Legal Consulting, Multitasking, Relationship Management, Working Independently.

2 days ago

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Claims Investigator Jobs in New Jersey

Investigator Ethos Risk Services

Entry-Level Investigator Ethos Risk Services

Associate SIU Investigator The Travelers Companies Inc

Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

SIU Investigator Centene Corporation Group

Asset Protection Investigator Saks Global Enterprises LLC

Investigator II Horizon Healthcare Services

Investigator II Blue Cross and Blue Shield Association

CPC Investigator Horizon Healthcare Services

CPC Investigator Blue Cross and Blue Shield Association

Surveillance Investigator VRC Investigations

Manager, Business Compliance Requests for Information (RFI) CVS Health Corp

Large Loss Property Adjuster - Field Estimating - New Brunswick, NJ Allstate Insurance Company

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