83 Results for

Claims Investigator Jobs in Silver Lake, CA

Jobs

Los Angeles, CA28 days ago

$45–$55.53 Per Hour
Temporary
Contractor
Full-time

This position independently manages full-cycle investigations from intake through closure, develops investigative strategies, prepares evidentiary packages for regulatory or law enforcement referral, and provides clinical and operational insight into healthcare billing patterns and provider behaviors. Strong understanding of coding and reimbursement structures (including Current Procedural Terminology (CPT), Healthcare Common Procedure Coding Systems (HCPCS), International Classification of Diseases (ICD-10)), medical billing, and claims review processes.

Los Angeles, CA28 days ago

$43.29–$48.29 Per Hour
Temporary
Contractor
Full-time

After making a conditional offer and running a background check, if we are concerned about conviction that is directly related to the job, applicants will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report. Minimum of 3 years of experience in healthcare fraud investigation/detection and/or healthcare related specialty including but not limited to; Pharmacy, DME, Mental Health, Behavioral Health, Hospice, Home Health, Dental etc.

Los Angeles, CA28 days ago

$42.71–$55.53 Per Hour
Temporary
Contractor
Full-time

The Special Investigation Unit Investigator III performs in-depth evaluation of potential fraud & abuse cases and develops complex investigations that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for fraud, waste & abuse. After making a conditional offer and running a background check, if we are concerned about conviction that is directly related to the job, applicants will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Los Angeles, CA28 days ago

$32.30–$41.99 Per Hour
Temporary
Contractor
Full-time

Uses knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability, reimbursement methodologies, and relevant laws to find suspicious patterns in claims data, provider enrollment data, and other sources. After making a conditional offer and running a background check, if we are concerned about conviction that is directly related to the job, applicants will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Los Angeles, CA30 days ago

$55–$63.86 Per Hour
Temporary
Contractor
Full-time

Provide leadership to investigators and be accountable for tracking KPI’s, metrics, recovery, and savings, etc., provides feedback to staff on performance, resolves problems, provides guidance to team members when needed, and takes necessary steps to address poor performance, including corrective action up to termination. Manage the day-to-day operations of the SIU by leading a team of investigators, driving key initiatives across the team to improve processes and generate incremental Fraud and Abuse (F&A) opportunities, and executing the overall strategic direction of the SIU.

Los Angeles, California16 days ago

$26–$30 Per Hour

The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 700+ employees and affiliates worldwide. CoventBridge Group is a global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs.

Los Angeles, California13 days ago

$30–$38 Per Hour

California, CA30+ days ago

Remote

$90,000–$105,000 Per Year

Job Responsibilities Determine compensability and/or coverage issues for loss time workers' compensation claims Effectively manage a caseload of loss time claims from numerous jurisdictions Negotiate and direct settlements under management's review Gather medical and factual evidence to determine compensability Direct outside investigation and handle litigation files within given authority Coordinate and maintain contact with claimants and/or their attorneys, outside investigators, and rehabilitation personnel as well as routine contact with insureds, account liaisons and medical providers Requirements Qualifications A minimum of 3 years of experience required Experience handling claims in multiple jurisdictions Bachelor's degree required SIP Certification required Carrier experience preferred Experience in handling lost time or litigated claims Familiarity with medical terminology Demonstration of strong organizational, problem solving, negotiation, and conflict resolution skills Excellent verbal and written communication skills needed About Us biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. BHDIC and the team at biBerk are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.

Los Angeles, CA18 days ago

Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients.

Los Angeles, CA18 days ago

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.

Los Angeles, CA30+ days ago

$83,916–$138,914 Per Year

In the interview, the following competencies may be evaluated: Judgment and Decision Making; Attention to Detail; Self-Management; Fact Finding; Interpersonal Skills; Job Knowledge, including knowledge of: objective symptoms of use of alcohol and commonly used controlled substances sufficient to recognize when a person may be under the influence; interviewing techniques sufficient to obtaining necessary background information; investigative techniques and concepts of background investigations to collect accurate and complete information; and other necessary knowledge, skills, and abilities. REQUIREMENT(S)/MINIMUM QUALIFICATION(S) Five years of full-time paid experience within the last ten years as a California peace officer that includes experience in background investigations for employment, internal affairs investigations, or in-depth investigations of criminal matters; or A valid Private Investigator's license issued by the California Bureau of Security and Investigative Services; or 900 cumulative hours of paid experience within the last five years conducting background investigations for public safety positions while employed with the City of Los Angeles.

Los Angeles, CA30+ days ago

$25–$35 Per Hour

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

Los Angeles, CA30+ days ago

$36.63–$57.49 Per Hour

As a SIU Field Investigator, you will conduct investigations of suspected cases of fraud or other illegal activities against the Company, including interviewing, database inquiries, taking statements, and locating sources of information and witnesses. Experience handling in-person or phone statements from various parties in an investigation in a way that builds GEICO's customer base and promotes customer satisfaction through efficient, accurate, and courteous interactions.

Glendale, CA13 days ago

We believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be highly motivating and productive. The Special Investigator 1 will complete field and desk assignments that support insurance claims referred to and accepted for investigation by the Special Investigative Unit.

Los Angeles, CA24 days ago

Remote

$45–$55 Per Hour

The SIU Clinical Healthcare Fraud Investigator III leads complex, high impact investigations into fraud, waste, and abuse across multiple healthcare service lines. The Intersect Group partners with mission focused healthcare organizations dedicated to improving access, quality, and equity of care for large and diverse member populations.

CA30+ 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. Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs.

Los Angeles, CA19 days ago

Remote

$50–$60 Per Hour

Trusted by Fortune 100 companies and emerging disruptors alike, we challenge conventional ways of working, drive growth, and pave the way for long-term success through bold innovation and fearless collaboration. We've built a global network of over 2,600 experts across four regions, providing a comprehensive suite of solutions across on-demand talent, next-generation consulting, and outsourced services to support organizations at every stage of their growth journey.

Anaheim, California29 days ago

$24–$30

Position Overview:The Surveillance Investigator is responsible for conducting covert surveillance, documenting claimant activities, obtaining video evidence, and preparing detailed reports for workers’ compensation and insurance-related investigations. Equipment Requirements:Candidates must possess and maintain the following: Registered and reliable vehicle suitable for surveillance operations.

Monterey Park, California13 days ago

$20–$24 Per Hour

Los Angeles, CA30+ days ago

$77,120–$147,390 Per Year

As a dedicated SIU Investigator, you will, 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. 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.

CA30+ days ago

$56,200–$101,000 Per Year

Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.

Education/Experience: Bachelor's Degree in Business, Criminal Justice, Healthcare, related field or equivalent experience required.

Los Angeles, CA30+ days ago

Remote

$43–$48 Per Hour

This position plays an important role in identifying risk patterns, supporting enforcement actions, and safeguarding healthcare program integrity through data driven insights and detailed case development. Our client operates one of the largest public health programs in the country, delivering essential services to millions while maintaining a strong focus on compliance, integrity, and accountability.

Los Angeles, CA28 days ago

Remote

$40–$50 Per Hour

This senior SIU role handles high?impact cases and serves as a subject matter expert, mentor, and audit lead. Join the nations largest publicly operated health plan to lead complex healthcare fraud, waste, and abuse investigations across Medi?

Los Angeles, CA24 days ago

Remote

$42–$55 Per Hour

The Special Investigation Unit Investigator III plays a critical role in protecting healthcare program integrity through the investigation of complex fraud, waste, and abuse cases. You will analyze data, conduct detailed investigations, and collaborate with internal teams and external agencies to identify suspicious activity and support enforcement actions.

Costa Mesa, CA30+ days ago

$90,160–$141,120 Per Year

The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Companys sole discretion, consistent with the law. The Pharmacy Investigator Senior is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims.

Costa Mesa, CA30+ days ago

$20–$24 Per Hour

p>The pay range for this position at commencement of employment is expected to be between $20 and $24/hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience.

Achieve targets of investigative performance by identifying and addressing internal and external theft exposures; complete accident investigations and general liability claims reports.

New!

Los Angeles, CA2 days ago

$103,495.68–$147,241.20 Per Year

p>Veteran's Credit:

Pursuant to the County Charter and County policy, in all open competitive examinations (i.e., examinations open to everyone), the County of Los Angeles will add a credit of 10 percent of the total credits specified for such examination to the final passing score of an honorably discharged veteran, as well as the spouse of a deceased or disabled veteran, who served in the Armed Forces of the United States under specific conditions.

If you indicated experience in law enforcement as a full-time equivalent police officer as defined in Section 830.1 of the state of California Penal Code in Question #4 above, please indicate where this experience was gained and provide a detailed description of the duties performed: Payroll Title Employer Name (e.g., Agency, or County Department) Dates of Employment: FROM: (mm/dd/yy) - TO (mm/dd/yy) Duties performed Comments such as "see resume or application" WILL NOT be considered as a full response.

Los Angeles, CA13 days ago

$106,437–$161,313 Per Year

You 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. Most recent (i.e., usually within the last 18 months) final (not a mid-year review) official (i.e., signed by the rating official and in original format) annual performance appraisal must be submitted by reinstatement eligible applicants applying to a position with a higher grade or more promotion potential than previously held and current or former Land Management employees.

Glendale, CA30+ days ago

$69,557–$112,677 Per Year

Conduct investigations into fraud claims related to online transactions, pre-authorized drafts, altered checks, forged endorsements, unauthorized third-party transfers, financial exploitation, identity theft, and additional fraudulent activities. Handle high-priority and high-risk cases, such as outgoing wires, recovering funds, consumer complaints, large transactions, and potential Bank Secrecy Act or SDN list violations.

CA30+ 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.

Skills and attributes for success:

• The investigator will generate new investigations and continue with ongoing investigation and civil actions involving fraud in areas such as healthcare contracting and grants, as well as other fraud and abuse of federal public funds and programs.

WY8 days ago

Essential Functions:

Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity.

Glendale, CA30+ days ago

$146,632–$190,627 Per Year

Incumbent 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.

Woodland Hills, CA16 days ago

$78,320–$128,160 Per Year

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. 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.

Woodland Hills, CA28 days ago

$31.32–$33.44 Per Hour

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. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Santa Ana, CA30+ days ago

$61,396–$99,678 Per Year

Work with the Head of Global Asset Protection to proactively identify gaps/areas of improvement with respect to digital security systems (access control, video surveillance, video storage) or physical processes that create exposure to theft. Excellent analytical skills and broad experience documenting investigations with the ability to think outside the box, handle multiple projects simultaneously, and build relationships with internal and external stakeholders.

Los Angeles, CA30+ days ago

$124,085–$161,313 Per Year

GS-13 Applicants must have one year of specialized experience equivalent to at least the GS-12 level in the Federal Service that includes planning, conducting or leading federal investigations in one or more of the following areas: wire fraud, mail fraud, elder fraud, money laundering, public corruption, civil rights, embezzlement, violent crime involving criminal enterprises, and cyber-crimes including, but not limited to: business email compromise, account takeovers, internet fraud, and credit card fraud. If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, Non-career SES or Presidential Appointee employee in the Executive Branch, you must disclose this information to the Human Resources Office by providing a copy of your applicable SF-50, along with a statement that provides the following information regarding your most recent political appointment: Position title; Type of appointment (Schedule A, Schedule C, Non-career SES, or Presidential Appointee); Agency; and.

Santa Ana, California30+ days ago

Los Angeles, CA19 days ago

$112,556–$161,313 Per Year

Current permanent Federal employees with competitive status, Land Management Workforce Flexibility Act, CTAP/RPL/ICTAP and VEOA eligibles, Farm Service Agency permanent county employees, 30 Percent or More Disabled Veterans; Certain Former Overseas and Foreign Service Employees; Military Spouses; Interchange Agreement and Other Miscellaneous Authorities; People with Disabilities; Peace Corps and VISTA; and Reinstatement eligible candidates. Surplus or displaced employees eligible for CTAP, RPL, or ICTAP priority must provide: proof of eligibility (RIF separation notice, notice of proposed removal for declining a transfer of function or directed reassignment to another commuting area, notice of disability annuity termination), SF-50 documenting separation (as applicable), current performance appraisal with rating of at least "Fully Successful" or equivalent, and your most recent SF-50 noting position, grade level, and duty location with your application per 5 CFR 330.

Los Angeles, CA22 days ago

$97,793.52–$131,789.52 Per Year

Independently conducts internal investigations in the field by devising, organizing, and executing effective strategies related to interviewing complainants, subjects/ suspects, and various types of witnesses, and obtaining, documenting, and reviewing other factual evidence and records (i.e., body worn cameras, personnel records and files, incident reports, use-of-force review documents etc.) in order to reach supportable findings and conclusions. Veteran's Credit: Pursuant to the County Charter and County policy, in all open competitive examinations (i.e., examinations open to everyone), the County of Los Angeles will add a credit of 10 percent of the total credits specified for such examination to the final passing score of an honorably discharged veteran, as well as the spouse of a deceased or disabled veteran, who served in the Armed Forces of the United States under specific conditions.

Los Angeles, CA30+ days ago

Specializing in all types of accident claims, including automobile, motorcycle, bicycle, Uber/Lyft, or trucking accidents, slip and falls, dog bites, construction accidents and other wrongful conduct, the attorneys at Jacoby & Meyers have recovered over a billion dollars for their clients' personal injury and wrongful death claims caused by the negligence of a third party. The position will require traveling and driving to locations and may require being available outside of business hours and on some weekends, depending on investigation and as needed to meet and speak with clients.

Woodland Hills, California30+ days ago

About the Role:Join USA Express Legal & Investigative Service Inc. as an In-House Private Investigator, where you will play a crucial role in uncovering vital information and providing exceptional investigative services. Our clients appreciate our dedication to uncovering the truth, while our employees value the supportive and dynamic work environment that fosters growth and development.

Diamond Bar, California30+ days ago

One-year bodily injury liability claim handling experience or comparable liability claim handling experience, or successful completion of Travelers Claim Representative training program is required. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling processWhat Will You Do?.

Diamond Bar, California30+ days ago

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. Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.

Diamond Bar, California30+ days ago

Investigates 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.

Los Angeles, CA30+ days ago

$57,200–$80,300 Per Year

Technical Skills & Competencies: Preference for prior experience as MO Claim Examiner in workers' compensation as a lost time examiner, or similar examiner experience in short-term / long-term disability, auto personal injury protection / medical injury, or general liability claims. Prior workers' compensation claim handling experience or other similar type of claim handling experience is preferred (healthcare, short-term / long-term disability, auto personal injury protection / medical injury, or general liability).

Woodland Hills, CA30+ days ago

Join USA Express Legal & Investigative Service Inc. as an In-House Private Investigator, where you will play a crucial role in uncovering vital information and providing exceptional investigative services. Our clients appreciate our dedication to uncovering the truth, while our employees value the supportive and dynamic work environment that fosters growth and development.

Diamond Bar, CA30+ days ago

$104,000–$171,700 Per Year

Diamond Bar, CA30+ days ago

$67,000–$110,600 Per Year

One-year bodily injury liability claim handling experience or comparable liability claim handling experience, or successful completion of Travelers Claim Representative training program is required. 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.

Diamond Bar, CA30+ days ago

$67,000–$110,600 Per Year

p>To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/.

Santa Ana, CA30+ days ago

Looking for private investigator or anyone is in training to become an investigator to handle field assignments for personal injury cases. We pay hourly rate plus IRS applicable mileage.

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Claims Investigator Jobs in Silver Lake, CA

SIU Clinical Healthcare Fraud Investigator III Solugenix Corp

Special Investigation Unit Investigator II Solugenix Corp

Special Investigation Unit Investigator III Solugenix Corp

SIU Investigative Analyst III Solugenix Corp

Manager of Special Investigations Unit Solugenix Corp

Claims Investigator - Full Time CoventBridge Group

SIU Investigator Allied Universal

Workers'' Compensation Claims Representative - California biBerk Business Insurance Inc

Investigator Ethos Risk Services

Entry-Level Investigator Ethos Risk Services

BACKGROUND INVESTIGATOR 1764 City of Los Angeles

Surveillance Investigator Lemieux & Associates LLC

SIU Field Investigator - Los Angeles, CA GEICO GENERAL INSURANCE COMPANY

SIU Investigator - Fast Team Kemper Corp

SIU Clinical Healthcare Fraud Investigator III (ATL) The Intersect Group

Auditor/Investigator I Qlarant Quality Solutions Inc

SIU Investigator Resources Connection Inc

Surveillance Investigator A.N. Investigations Inc.

Surveillance Investigator Allied Universal

SIU Investigator Intermediate - Field USAA

SIU Investigator Centene Corporation Group

Special Investigation Unit Investigator II (ATL) The Intersect Group

Special Investigation Unit Investigator III (PHX AND DALLAS) The Intersect Group

Special Investigation Unit Investigator III (ATL) The Intersect Group

Pharmacy Investigator Senior Elevance Health Inc

Asset Protection Investigator Saks OFF 5TH

INVESTIGATOR II, PUBLIC DEFENDER Los Angeles County

Criminal Investigator US Department of State

Fraud Investigator I Global Credit Union Home Loans LLC

Affirmative Civil Enforcement ACE Investigator Contact Government Services LLC

Auditor/Investigator II Qlarant Quality Solutions Inc

Supervisory Criminal Investigator (ASAC) U.S. Department of Justice

Investigator II Elevance Health Inc

Investigator Assistant (US) Elevance Health Inc

Asset Protection Investigator (GME + eBay) Collectors Holdings, Inc.

Criminal Investigator U.S. Department of Justice

Asset Protection Investigator (GME + eBay) Collaborative Solutions

Investigator U.S. Department of Agriculture

INVESTIGATOR II Los Angeles County

Investigator Attorney Jacoby and Meyers Attorneys LLP

In-House Private investigator USA Express Legal & Investigative Service

Auto Liability Claim Rep Travelers

Major Case Commercial General Liability Claim Representative Travelers

General Liability Inside Claim Representative Travelers

Claim Representative Chubb Ltd

In-House Private investigator USA Express Legal & Investigative Service Inc.

Major Case Commercial General Liability Claim Representative The Travelers Companies Inc

Auto Liability Claim Rep The Travelers Companies Inc

General Liability Inside Claim Representative The Travelers Companies Inc

Private investigator USA Express Legal & Investigative Service Inc.

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