Health Plan Claims Analyst I- Environmental Medicine Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental MedicineNew York, NY$64,526.72–$81,675 / yearMount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.
SIU Investigator Allied UniversalSIU InvestigatorBrooklyn, NY$32–$38 / hourAcquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance. High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud.
SIU Investigator - NY Labor Law Allied UniversalSIU Investigator - NY Labor LawManhattan, New York$32–$40 / hourAcquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance . High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud .
Investigator Ethos Risk ServicesInvestigatorLong Island, NYPart 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.
Registered Nurse - Nursing Home Surveyor/Complaint Investigator GreenLife Healthcare StaffingRegistered Nurse - Nursing Home Surveyor/Complaint InvestigatorNew Rochelle, NYParticipate in surveys or complaint investigations to include allegations of abuse and neglect, and perform surveillance activities/tasks at nursing homes (long-term care) to determine compliance with Federal and State regulations. Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
NewSurveillance Investigator Lemieux & Associates LLCSurveillance InvestigatorNew York, NY$25–$32 / hourPart timeRequired Skills and Abilities:Digital video camcorder use and operationWorking Knowledge of Windows, Microsoft Office, Internet Explorer, and Adobe AcrobatEffective written communication/ skills and report writingStrong organizational and time management skillsDemonstrated strong interpersonal communication skills and the ability to effectively build rapportFlexibility to work varied/irregular hours and days including holidays and weekendsAble to work well independentlyAble to travel extensively throughout assigned territory and effectively manage expensesQualifications:Experience conducting surveillance as a private investigator is a mustBi-lingual is a plusAssociates/Bachelor, Degree in Criminal Justice or Related Field is a plusAbility to conduct written and recorded statements is a plusAbility to accurately photograph evidence i.e., accident scenes, vehicle damage, etc. is a plusAbility and willingness to travel as necessaryFlexibility to work varied/irregular hours and daysStrong computer and Internet skillsPossess a valid state-issued driver's licensePossess a reliable vehicle, digital camera and computer with Windows Operating System, Microsoft Word and Internet connectionMust have the personal pride to get your work product in on timeCompetitive starting payTravel time compensationReport writing compensationPay rate: $25-$32Physical Demands and Work Environment:While performing the duties of this job, the employee is typically in the community. Job Description Field InvestigatorJob Classification: Non-ExemptPosition Summary:A majority of the work activity involves field surveillance requiring the investigator to obtain high quality videotape documentation of claimants who have filed workers compensation and liability/personal injury claims.
NewSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)NY$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.
Fire Investigator EFI Global IncFire InvestigatorLong Island, NY$70,000–$85,000 / 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.
Fire Investigator EFI GlobalFire InvestigatorLong Island, NY$70,000–$85,000 / 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.
SIU Investigator Centene Corporation GroupSIU InvestigatorNJ$56,200–$101,000 / yearCollaborates 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.
Registered Nurse - Nursing Home Surveyor/Complaint Investigator Greenlife Healthcare StaffingRegistered Nurse - Nursing Home Surveyor/Complaint InvestigatorNew Rochelle, NY$124,800 / yearParticipate in surveys or complaint investigations to include allegations of abuse and neglect, and perform surveillance activities/tasks at nursing homes (long-term care) to determine compliance with Federal and State regulations. Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
Special Investigation Unit Investigator Centene Corporation GroupSpecial Investigation Unit InvestigatorNJ$56,200–$101,000 / yearEducation/Experience: Bachelor's Degree Business, Criminal Justice, Healthcare Administration, Public Health, or a related field; or equivalent experience (or) An Associates or Bachelor's degree in criminal justice or a related field; (or) employment as an investigator in the MMCO's SIU on or before the effective date of this SubPart required. Minimum of five (5) years in healthcare field working in fraud, waste and abuse investigations and audits, (or) five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, (or) seven years of professional investigation experience involving economic or insurance related matters.
NewHospital Care Investigator Atria ConsultingHospital Care InvestigatorNew York, NY$20–$24 / hourPay range: *** hrly -*** hrly A member of the revenue cycle process, billers are responsible for reviewing accounts, correcting claim edits, preparing and completing claims for submission to payers, posting all types of payments, and updating patient accounting systems. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity).
Affirmative Civil Enforcement (Ace) Investigator CONTACT GOVERNMENT SERVICESAffirmative Civil Enforcement (Ace) InvestigatorNew York, NY$51,435.30–$66,131.10 / yearPerforms 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 to 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.
NewSenior Investigator UnitedHealth Group Inc.Senior InvestigatorEast Brunswick, NJ$60,200–$107,400 / yearWe are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes.
NewEEO Investigator HirePower Personnel Inc.EEO InvestigatorNew York, NY$61–$72 / hourOur client provides top-ranked care, dozens of inpatient and outpatient specialties, and mental health services with a team of highly trained and caring medical professionals who are compassionate, culturally competent and patient centered. Many of their roles are temp-to-hire, giving our client and our candidates the opportunity to ensure they are the right fit for a full-time position, as this comes with career advancement opportunities and excellent benefits.
Supervisory Criminal Investigator U.S. Department of LaborSupervisory Criminal InvestigatorNew York, NY$148,222–$192,694 / yearQualifying specialized experience for the GS-14 level includes at least four (4) of the following: Serves as a lead agent, directing and/or guiding others in completing criminal investigations into financial crimes and fraud, federal programs, contracts or grant fraud, and employee integrity offenses; Oversees day-to-day operations of investigative teams; Provides technical guidance to junior staff and resolves complex issues requiring policy interpretation; Conducts interviews, surveillance, examination of records and executes undercover operations; and/or. Assists the SAC in establishing regional investigative priorities and annual plans; develops implementation strategies for assigned staff and units; and contributes to OIGs multi-year strategic planning by identifying emerging risks, fraud trends, and opportunities for proactive initiatives.
Surveillance Investigator Allied UniversalSurveillance InvestigatorEdison, New Jersey$20–$23 / 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. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Surveillance Investigator - Bronx Allied UniversalSurveillance Investigator - BronxThe Bronx, New York$25–$28 / 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. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .