NewCompliance Audit / Investigator / Coder - CCS / CPC / or CCA MedStar HealthCompliance Audit / Investigator / Coder - CCS / CPC / or CCAWashington, DC$65,062–$117,291Performs concurrent and retrospective coding and documentation or clinical review audits of respective plan service areas including Behavioral Health services and other duties as assigned to detect potential compliance and/or fraud waste and abuse. Conducts provider coding and documentation audits for specific provider types including behavioral health for MFC DC depending upon the health plan that this role supports (MFC MD or MFC DC).
SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorWashington, DC$25–$32 / hourPart timeNotary license strongly (preferred).Bilingual ability and/or degree in Criminal Justice or related field (preferred).Willingness to travel; flexible schedule (varied/irregular hours).Strong computer and internet skills. Accurately photograph evidence (accident scenes, vehicle damage, etc.).Skills & ExperienceExperience handling complex SIU/Claims cases.
Senior Property Adjuster (Commercial Property Claims) - Washington, DC Engle Martin & Associates, Inc.Senior Property Adjuster (Commercial Property Claims) - Washington, DCWashington, DCPHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.
NewInvestigator Ethos Risk ServicesInvestigatorBaltimore, MDPart 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.
Fire Investigator EFI Global IncFire InvestigatorBaltimore, MDRemote$55–$65 / hourNowHiring #CertifiedFireInvestigator #FireInvestigator #FireInvestigation #IAAICFI #FireForensics #OriginAndCause #ForensicInvestigation #RemoteJobs #CareerOpportunity #ProfessionalGrowth #GreatPlaceToWork #PropertyClaims #ExpertWitness #JoinOurTeam. Over the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global leader in engineering failure analysis, origin-and-cause investigations, environmental consulting, laboratory testing and specialty consulting.
NewUI Professional III (BPC Fraud Investigator) State of MarylandUI Professional III (BPC Fraud Investigator)Baltimore City, MDRESPONDS TO TELEPHONE AND/OR EMAIL INQUIRIES FROM BOTH INTERNAL AND EXTERNAL CUSTOMERS; GATHERS AND ANALYZES INFORMATION FROM CLAIMANTS TO DETERMINE THE APPROPRIATE TYPE OF UNEMPLOYMENT INSURANCE CLAIM;Â MAINTAINS AND UPDATES CLAIMANT ACCOUNT INFORMATION; RESEARCH AND ANSWERS CLAIMANT QUESTIONS REGARDING UNEMPLOYMENT INSURANCE BENEFITS; OBTAINS AND RECORDS EARNINGS AND EMPLOYMENT INFORMATION; EXAMINES CLAIM HISTORY TO ENSURE PROMPT AND ACCURATE PAYMENT OF BENEFITS; CONDUCTS BULK PROCESSING CLAIMS; ANALYZES REPORTS TO DETERMINE AND RESOLVE ISSUES REGARDING UNEMPLOYMENT INSURANCE CLAIMS; PRESENTS UNEMPLOYMENT INSURANCE INFORMATION OFFSITE DURING RAPID RESPONSE AND BULK CLAIM SESSIONS; CONDUCTS SEPARATION, AND/OR NON-SEPARATION FACT FINDING INTERVIEWS AND DOCUMENT INFORMATION GATHERED; APPROVES OR DISQUALIFIES CLAIMS BY APPLYING UNEMPLOYMENT INSURANCE LAWS, REGULATIONS, AND/OR DIRECTIVES; EVALUATES UNEMPLOYMENT INSURANCE CLAIMS TO DETECT IMPROPER PAYMENTS AND FRAUD. Notes: Candidates may substitute the possession of a Bachelor''s degree from an accredited college or university and two years of experience in a public/or private agency rendering and/or determining eligibility for a Human Service Program or other programs for the required experience.
Lead SIU Investigator Centene Management CompanyLead SIU InvestigatorWashingtonRemoteProvides direction and guidance to staff who investigate and remediate compliance and fraud, waste, and abuse related matters; while maintaining an investigative workload of moderate to high complexity. Bachelor's Degree in related field; or Associate's degree with 6 years related experience; or High School Diploma/GED with 7 years related experience.
PUBLIC NOTICE- DEA Criminal Investigators U.S. Department of JusticePUBLIC NOTICE- DEA Criminal InvestigatorsDC$48,854–$82,938 / yearS.A.A. is based on (1) class standing, (2) grade-point average, or (3) honor society membership: Class Standing: Applicants must be in the upper third of the graduating class, based on completed courses; Grade Point Average: Applicants must have a grade point average of: 3.0 or higher: 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: 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; OR; Election to membership in a national scholastic honor society: Applicants can be considered eligible based on membership in one of the national scholastic honor societies recognized by the Association of College Honor Societies OR; COMBINATION OF EDUCATION AND EXPERIENCE: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. Conducts complex criminal investigations targeting narcotics and drug related activities; Prepares comprehensive and succinct criminal investigative reports and prepares and delivers briefings for senior personnel and other Federal, state, and local agencies; Identifies and apprehends drug traffickers and arresting individuals engaged in criminal drug activities; Gathers and analyzes evidence through investigative leads, seizures, arrests, execution of search warrants, and a variety of other means; Testifies on behalf of the Federal government in court or before grand juries.
Surveillance Investigator Allied UniversalSurveillance InvestigatorBaltimore, Maryland$20–$23 / hourFull timeThe 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. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
EEO and Workplace Investigator HR AnewEEO and Workplace InvestigatorColumbia, MDFounded in 1999, HR Anew is a nationally WBENC certified woman owned small business that provides human resources advisory, workplace investigation, talent, leadership development, and organizational solutions to government, commercial, nonprofit, healthcare, and educational organizations. Our investigation services are supported by a managed service model that includes investigator recruitment and onboarding, training, case assignment, program management, quality review, performance monitoring, reporting, and executive oversight.
Criminal Investigator (Deputy U.S. Marshal) U.S. Department of JusticeCriminal Investigator (Deputy U.S. Marshal)Washington, DC$54,485–$70,307 / yearThe 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.
Investigator Sr AmeriHealth CaritasInvestigator SrWashington, DCRemote$92,600–$126,200 / yearWe offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. The Investigator is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving the full range of products at the AmeriHealth Caritas Family of Companies (ACFC).
SIU Senior Analyst, Lead Investigator (Must Reside in Maryland) CVS Health CorpSIU Senior Analyst, Lead Investigator (Must Reside in Maryland)MD$46,988–$112,200 / yearThe lead reviewer is accountable for the validation of existing Fraud, Waste and Abuse business rules/leads designed to detect aberrant billing patterns as reviewing incoming referrals. 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.
NewCriminal Investigator US Department of StateCriminal InvestigatorWashington, DC$147,899–$192,275 / yearYou must submit a DD-214 Certificate of Release or Discharge from Active Duty (Member Copy 4 preferred) showing the dates you served as well as your type of discharge and qualifying service campaign medals OR if you are still on active duty, you MUST submit a certification on letterhead from your military branch which contains your military service dates, expected date of discharge or release, and the character of service to show that your military service was performed under honorable conditions. Plans, coordinates, and conducts investigations involving threats and crimes directed against U.S. Government (USG) personnel and facilities throughout the U.S. Co-manages the Uniformed Protection Officer (UPO) contract consisting of 1100+ armed officers providing access control to nearly 80 DoS facilities throughout the U.S. as well as a K-9 program supporting National Capital Region (NCR) operations.
Supervisory Criminal Investigator (ASAC) U.S. Department of JusticeSupervisory Criminal Investigator (ASAC)Washington, DC$148,222–$192,694 / yearIncumbent presents the mission of the OIG and specifically of the Investigations Division to Justice officials and employees, and participates in all phases of program planning and policy formulation for the Field Office by developing and presenting to the SAC methodologies for those DOJ components investigated, ensuring operational and administrative activities are conducted in an efficient and effective manner. Work assignments include, but are not limited to: Provides leadership to subordinate Criminal Investigators and other staff by establishing guidelines and performance expectations by setting priorities and prepares schedules for completion of work.
NewSenior Criminal Investigator (SSA) U.S. Department of JusticeSenior Criminal Investigator (SSA)Washington, DC$125,776–$192,694 / yearPlans, organizes and personally conducts investigations with regard to a wide variety of allegations received by the OIG that typically involve extremely complex, difficult, or sensitive criminal or administrative investigations of major importance and high-level interest and misconduct allegations involving high-ranking officials of the Department of Justice. Serves as a highly-skilled investigator and lead a team of investigators and other OIG employees, in conducting the most sensitive, complex and challenging investigations and assists the field office management in the overall direction and application of resources to complete priority investigations.
Criminal Investigator - Special Agent U.S. Department of JusticeCriminal Investigator - Special AgentWashington, DC$115,711–$158,322 / yearStatus Candidates (Merit Promotion and VEOA Eligibles) Career transition (CTAP, ICTAP, RPL) Federal employees - Competitive service Individuals with disabilities Military spouses Peace Corps & AmeriCorps Vista Special authorities Veterans. To be well qualified, you must satisfy all qualification requirements for the vacant position and (for scored examining) score 85 or better on established ranking criteria OR (for category rating criteria) rate equivalent to the Highly Qualified or better category using established category rating criteria.
Investigator U.S. Department of JusticeInvestigatorWashington, DC$143,913–$187,093 / yearSpouse of service members killed while on active duty: documentation showing a) the member was released or discharged from active duty due to his or her death while on active duty; b) the member of the armed forces was killed while serving on active duty; c) proof of the widow or widowers marriage to the member of the armed forces (i.e., a marriage license or other legal documentation verifying marriage); and d) a statement certifying that the individual seeking to use the authority is the un-remarried widow or widower of the service member. Specialized experience is defined as: 1) Conducting sensitive investigations into allegations of sexual misconduct and/or related allegations of retaliation; 2) Applying trauma-informed methods and/or best practices in the field of sexual misconduct, and to collaborate with and monitor Components efforts to ensure that all individuals who are engaged in receiving or responding to reports of sexual misconduct have received proper training on trauma-informed victim-centered investigatory approaches; AND.
NewSupervisory Criminal Investigator (Threat Management Branch Chief) U.S. Department of Homeland SecuritySupervisory Criminal Investigator (Threat Management Branch Chief)Washington, DC$144,493–$187,847 / yearSpecialized Experience: You qualify for the GS-14 grade level if you possess one year of specialized experience, equivalent to the GS-13 grade level in the Federal government, performing duties such as: Analyzing and evaluating regional criminal investigative programs, policies, procedures to ensure effectiveness of operations; Providing technical advice and guidance to criminal investigators and staff regarding critical operations related to criminal investigative programs; Leading criminal investigations and modifying investigative plans to address criminal activity or potential threats; and. Provide evidence of your intellectual disability, severe physical disability, or psychiatric disability obtained from a licensed medical professional (e.g., a physician or other medical professional certified by a state, the District of Columbia, or a U.S. territory to practice medicine); a licensed vocational rehabilitation specialist (i.e., state or private); or any Federal agency, state agency, or agency of the District of Columbia or a U.S. territory that issues or provides disability benefit.
Fire Investigator EFI GlobalFire InvestigatorBaltimore, MD$50,000–$65,000 / yearOver the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global leader in engineering failure analysis, origin-and-cause investigations, environmental consulting, laboratory testing and specialty consulting. Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.