36 Results for

Claims Investigator Jobs in North Carolina

Jobs

Raleigh, NC30+ days ago

p>QUALIFICATIONS (MUST HAVE): High school diploma or equivalent Post offer, must be able to successfully complete the Allied Universal Investigations' training/orientation course Minimum of one (1) year of verifiable work experience, preferably involving investigations or other protective service-related field Flexibility to work varied and irregular hours/days including weekends and holidays Ability to type reports in Microsoft Word format with minimal grammatical and punctuation errors Proficient in utilizing laptop computers, video cameras and cell phones Capable of maintaining focus and multitasking effectively in a dynamic environment Demonstrated ability to manage stressful situations with composure and professionalism Ability to work in a very independent environment.

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.

Charlotte, NC15 days ago

$110,000–$150,000 Per Year

li>Coordinate and direct all relevant claims to NFP Subject Matter Experts spanning all key construction-related lines of coverage (including general liability, workers' compensation, commercial auto, builders' risk, professional liability, cyber, pollution, wrap-up, property, inland marine, surety, and subcontract default insurance) to ensure alignment and effective claims management.

15+ years of experience managing construction claim programs, with strong exposure to general liability, workers' compensation, commercial auto, builders' risk, professional liability, cyber, pollution, wrap-up, property, inland marine, surety, and subcontract default insurance and related casualty lines.

Asheville, NC30+ days ago

p>Join Lemieux & Associates, a trusted leader in investigative services, and make an impact with your surveillance expertise. Our leadership team brings over 25 years of field experience and is committed to fostering a professional, results-driven environment.

High Point, NC12 days ago

p>What You'll Do:

As a Special Investigator, you will conduct basic to moderately complex claims investigations on potentially suspect/inflated auto, workers' compensation, and commercial claims which may include but is not limited to compiling and analyzing information from internal and external sources, conducting interviews, hiring independent contractors, and referring claims to various law enforcement entities as required by law.

Motivate the claim staff to combat fraud and inflated claims using techniques such as creating office banners and visual aids, publishing specific case results and conducting meetings.

NC30+ days ago

$46,988–$122,400 Per Year

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.

Charlotte, NC30+ days ago
Work may involve standing, sitting, walking (even, uneven areas), occasional lifting (overhead, waist level) from floor, bending, frequent near vision use for reading and computer use. Work environment may involve exposure to various weather conditions, automotive fumes, fluids, noise, smells, sharp edges and bump hazards that require continuous use of personal protective equipment, i.e., safety glasses, gloves, and head protection.

Work At Home, NC30+ days ago
$66,330–$145,860 Per Year
The position plays a key role in identifying fraud risks, supporting program integrity efforts, and helping to prevent financial losses related to fraud, waste, and abuse. Directs complex investigations, including data analysis, interviews, and document review, to identify potential fraud, waste, and abuse, including NSA-related activity.

Raleigh, NC30+ days ago
$54,485–$70,307 Per Year
p>The mission of the USMS includes protection of the judiciary, court security, witness security, asset forfeiture, apprehending fugitives and violent offenders, apprehending and prosecuting unregistered sex offenders, prisoner transportation, management, and custody, and providing assistance in matters of Federal emergencies and other critical incidents. This specialized experience must be gained in a full time certified law enforcement officer position(s) which includes:
Independently execute and enforce the civil and/or criminal process;
Plan the execution of warrants of arrest;
Plan and carry out investigations;
Execute warrants of arrest;
Lead security assignments for court proceedings in criminal and/or civil trials; or.

NC30+ days ago
Remote
$56,200–$101,000 Per Year
Licenses/Certifications: Coding certification from an accredited organization (American Academy of Professional Coders or American Health Information Management Association), RN, LPC, LPN, LCSW, LMHC, PT, OT, or ST or related license. Ideal background includes reviewing medical records for fraud investigations, as well as experience from a specialist physician's office focused on record review and documentation quality.

Charlotte, NC30+ 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.

NC30+ days ago
$50,463.44–$85,787.86 Per Year
li>A background check may be required and may include criminal history, motor vehicle records, sex offender registry checks, pre-employment drug screening, SBI fingerprinting, and, if applicable, a National Practitioner Data Bank (NPDB) check. The Income Maintenance Investigator II is responsible for working independently in investigation fraud or alleged fraud cases in the income maintenance programs of Johnston County Department of Social Services.

NC30+ days ago
Remote
$70,000–$120,000 Per Year
Our Total Rewards program includes industry-leading compensation and benefits plus additional incentives that are designed to meet your needs and those of your family so you can get the most out of your career and your life, including:
Time Away: Program starts at 20 paid time off days in addition to 11 paid holidays and 8 hours of volunteer time off yearly (time off days are prorated based on start date and program varies based on full or part-time status and management level).
Supporting your Health & Well-being: flexible health and insurance options including medical, dental and vision, employee, spouse and child life insurance, short- and long-term disability, pre-tax Health Savings Account with employer contributions, Healthcare FSA, critical illness, accident & hospital indemnity insurance, and a total well-being program that helps you and your family stay on track physically, socially, emotionally, and financially.

Wake County, NC26 days ago
$55,823–$69,000 Per Year
Bachelor's degree in accounting, finance, business administration or criminal justice from an appropriately accredited institution, with eighteen credit hours of accounting coursework and two years of experience in auditing and/or investigating tax, financial, or securities crimes; or equivalent combination of education and experience. The primary purpose of this position is to perform investigations in the area of criminal and civil Medicaid fraud schemes, patient abuse or neglect, and misappropriation of recipient funds by conducting and participating in a wide variety of case investigations involving financial analysis.

NC14 days ago
Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure.
Essential Functions:
Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity.

Durham, NC30+ days ago
We 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. Location: Hybrid1: This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.

NC26 days ago
$35.05–$42.84 Per Hour
WHAT YOU'LL DO: Fraud Monitoring & Detection: You'll use multiple fraud management systems and reporting tools to proactively monitor accounts and identify suspicious monetary and non-monetary activity across products like Zelle, checks, transfers, and new accounts. IMPACT YOU'LL MAKE: As a Fraud Investigator II, you'll play a critical role in protecting members and safeguarding financial assets by identifying and resolving fraudulent activity across a range of products and services.

Charlotte, NC11 days ago
$85,600–$141,200 Per Year
p>To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/.
Directly investigate each claim through prompt and strategically-appropriate 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.

Charlotte, NC16 days ago
Remote
$80,000–$132,000 Per Year
li>Serve as a subject matter expert providing strategic oversight of complex construction-related general liability claims, including third-party bodily injury, property damage, and completed operations exposures, and advising on coverage, liability, damages, and resolution strategies. This role emphasizes claims management with accountability for strategic oversight of assigned GL claims, reserve and exposure evaluation, coverage and claims advocacy, and collaboration with the broader Construction & Infrastructure Claims Team to drive timely, cost‑effective, and defensible resolutions.

NC16 days ago
$15–$20 Per Hour
p>By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. This position also provides support to CR1 staff during periods of high volume, which includes compiling claim packets and referring eligible claims with supporting documentation to collection vendors, excluding claims involving total losses.

Greenville, NC30+ days ago
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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.
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.

Clayton, NC30+ days ago
Driving Positions: must possess a valid Driver's License with at least one year of driving experience, a clean driving record (no major violations within last 36 months, no more than 1 accident in last 24 months, no more than one minor moving violation in last 24 months), a minimum level of insurance as required by Company policy, and the ability to safely operate a vehicle required. 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.

Charlotte, NC30+ days ago
p>RESPONSIBILITIES:
Ensure firearms ATF cATFliance processes and procedures are in adherence to Federal, State and Local Laws, ordinances, and regulations through coordinating detailed compliance inspections; analyze results of Federal (ATF FATF73, 3310.4, 3310.12, 3310.6, 3310.11) and state required paperwork, and internal documents to determine licensed facilities standing.
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.

Sanford, NC30+ days ago
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. Read More 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.

Charlotte, NC30+ days ago
Allied Universal Named to Forbes List of America's Best Employers by State IRVINE, Calif. Sept. 3, 2025 Allied Universal, the worlds leading security and facility services company, has been named to Forbes list of Americas Best Employers by State (2024), ranking in the top 100 for Arizona, Georgia, New Jersey and North Carolina. 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.

Fayetteville, NC30+ days ago
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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.
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.

Winston-Salem, NC30+ days ago
p>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.
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.

Raleigh, NC30+ days ago
p>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.
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.

New!
Charlotte, NC5 days ago
$77,120–$147,390 Per Year
li>
Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools. Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures.

NC30+ days ago
$87,700–$157,800 Per Year
Previous experience as a lead or supervisor in a pre-payment process managing cross functional teams or supervisory experience including hiring, training, assigning work and managing the performance of staff preferred. Position Purpose: Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends and schemes.

NC30+ days ago
Full-time
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Responsible for supporting assigned Director in meeting or exceeding the defined annual budget for the entire practice area/practice division (including proactive management of assigned resources to meet or exceed defined utilization targets, oversight of execution of profitable engagement work streams, and communication with clients as assigned or requested). Additional benefits include Flexible Spending Accounts, a robust Employee Assistance Program, and a suite of exclusive perks that enhance everyday life.

Time away matters—so we provide a generous paid time off program, including vacation, sick time, and paid holidays (with prorated options for eligible part-time employees).

At VERTEX, growth never stops.

Hickory, NC30+ days ago
p>The Customer Service Expert - youll live into Allstates 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 - youll 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.

New!
Cabarrus County, NC5 days ago
$48,920–$63,176 Per Year
p>The Criminal Investigations Section of the North Carolina Industrial Commission operates as a law enforcement agency and is responsible for conducting criminal investigations into cases of suspected workers' compensation fraud, employee misclassification, and violations related to workers' compensation claims involving employees, employers, insurers, health care providers, attorneys, and vocational rehabilitation providers. At the time of hire, or no later than 12 months from the Special Agent's first day of employment, the Special Agent is required to reside in one of the counties listed below:
Alamance, Anson, Cabarrus, Chatham, Davidson, Davie, Forsyth, Guilford, Montgomery, Moore, Randolph, Rockingham, Rowan, Stanly, Stokes, Surry, or Yadkin.

NC30+ days ago
p>Responsible for supporting assigned Director in meeting or exceeding the defined annual budget for the entire practice area/practice division (including proactive management of assigned resources to meet or exceed defined utilization targets, oversight of execution of profitable engagement work streams, and communication with clients as assigned or requested).
Senior Forensic Engineers are involved in a wide variety of tasks, including forensic investigations of residential, commercial, and/or mixed-use buildings, code research and construction document review, failure analysis, the scope of repair preparation, and report writing.

Chapel Hill, NC30+ days ago
$31.04–$44.62 Per Hour
p>Summary:
The Research Billing Coverage Analysis Coordinator will analyze protocol-driven clinical research services to ensure that both routine and research services are properly identified and billed in compliance with the Medicare Clinical Trial Policy, national and local laws and regulations, as well as institutional billing policies. Create coverage analyses in accordance with Medicares Clinical Trial Policy (NCD 310.1) and assist research staff within the clinical departments with the interpretation of related guidance and their effect on research billing processes.

New!
Guilford, North Carolina6 days ago
The Criminal Investigations Section of the North Carolina Industrial Commission operates as a law enforcement agency and is responsible for conducting criminal investigations into cases of suspected workers’ compensation fraud, employee misclassification, and violations related to workers’ compensation claims involving employees, employers, insurers, health care providers, attorneys, and vocational rehabilitation providers. The primary purpose of the Special Agent is to work as a law enforcement officer in the Criminal Investigations and Employee Classication Division and assist with the investigation of statutory violations related to workers’ compensation fraud and failure to obtain and maintain workers’ compensation insurance or qualify as a self-insured employer.

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Claims Investigator Jobs in North Carolina

Surveillance Investigator Allied Universal

Assistant Vice President: Construction Claims Account Executive NFP Corp

Surveillance Investigator Lemieux & Associates LLC

SIU Field Investigator Sentry Insurance Group

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

Automotive Product Investigator/Dealership Technician (Part-Time / On Call) V2X Inc

Fraud, Waste & Abuse (FWA) Investigator - No Surprises Act (NSA) CVS Health Corp

Criminal Investigator (Deputy U.S. Marshal) U.S. Department of Justice

Clinical Investigator I (Special Investigation Unit) Centene Corporation Group

Affirmative Civil Enforcement ACE Investigator Contact Government Services LLC

Income Maintenance Investigator II Johnston County Council

Senior Bank Fraud Investigator Ally Financial Inc

Financial Investigator State of North Carolina

Auditor/Investigator II Qlarant Quality Solutions Inc

Investigator II Elevance Health Inc

Fraud Investigator II Boeing Employees Credit Union

Technical Specialist, Construction Claim The Travelers Companies Inc

Assistant Vice President, Construction General Liability Claim Analyst (Remote, US) NFP Corp

Temporary Subrogation Claim Support Processor AAA Southern New England

Janitor - Part Time Allied Universal

Security Shift Supervisor Overnight Allied Universal

Firearms Inventory Controller Allied Universal

Security Site Supervisor Allied Universal

Janitor Allied Universal

Business Development Manager-Hybrid Allied Universal

Janitorial Lead Allied Universal

Maintenance Technician Allied Universal

Janitorial Supervisor Allied Universal

SIU Consultant (Triage) USAA

Manager, SIU Prepay Investigations Centene Corporation Group

Senior Forensic Engineer The Vertex Companies, LLC

Field Auto Adjuster - Hickory, NC Allstate Insurance Company

Special Agent State of North Carolina

Senior Forensic Engineer The Vertex Co Inc

Research Billing Coverage Analysis Coordinator UNC Health

Special Agent Insurance

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