SIU / Claims Investigator - Central / South VA Allied UniversalSIU / Claims Investigator - Central / South VACharlottesville, Virginia$25–$32 / 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 / Claims Investigator - Northern VA / DC Area Allied UniversalSIU / Claims Investigator - Northern VA / DC AreaFredericksburg, Virginia$25–$32 / 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 .
Western VA SIU / Claims Investigator - Part Time Allied UniversalWestern VA SIU / Claims Investigator - Part TimeLynchburg, Virginia$27–$36 / 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 - Part Time Allied UniversalSIU Investigator - Part TimeLynchburg, Virginia$27–$36 / hourFull timeAcquire 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 - Northern VA and MD Allied UniversalSIU Investigator - Northern VA and MDFredericksburg, Virginia$25–$32 / hourFull timeAcquire 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 - Central / South VA Allied UniversalSIU Investigator - Central / South VACharlottesville, Virginia$25–$32 / hourFull timeAcquire 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 .
Part Time SIU Investigator The Robison GroupPart Time SIU InvestigatorVirginia Beach, VirginiaThrough our operating brands, HVACi, StrikeCheck, National Fire Experts, Donan Engineering, BSC Forensics, Component Testing Laboratories, The Robison Group, VRC Investigations, TechLoss, Mecanica Scientific Services, and HMI we are respected as the industry leader for our scale and our track record of conducting expert, specialized, and accurate investigations. Qualified candidates are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire damages, auto accidents, commercial claims, finding missing persons, courthouse searches, and other investigative tasks.
Investigator Ethos Risk ServicesInvestigatorRichmond, VAFull 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.
Surveillance Investigator Allied UniversalSurveillance InvestigatorFredericksburg, VA$21–$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. RESPONSIBILITIES: Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability.
NewSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)VA$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.
NewSenior Fraud and Abuse Investigator/CPC/CFI/CFS/CHC/CFE/AHFI Sentara HospitalsSenior Fraud and Abuse Investigator/CPC/CFI/CFS/CHC/CFE/AHFIVirginiaRemoteExperience utilizing data analytics to identify high-risk providers and claims for pre-payment review within a healthcare payer, SIU, Program Integrity, or Payment Integrity environment is strongly preferred . Experience conducting pre-pay investigations, provider risk assessments, data mining, fraud, waste and abuse (FWA) analysis, and proactive identification of billing anomalies and emerging provider trends.
SIU Investigator Centene Corporation GroupSIU InvestigatorVA$56,200–$101,000 / yearLicenses/Certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or other related investigative, auditing, or compliance certification preferred. 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.
Investigator II - Special Investigations Unit ( Tennessee, North Carolina, Kentucky, Virginia ) West Bend Insurance CompanyInvestigator II - Special Investigations Unit ( Tennessee, North Carolina, Kentucky, Virginia )VARemote$68,000–$90,000 / yearCollaborative with internal stakeholders and external partners to evaluate and investigate suspicious insurance transactions (claims, underwriting, policy, etc.), collect evidence, support fraud detection programs, and communicate investigative findings to internal and external partners, regulators, and law enforcement. West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies.
Senior Fraud and Abuse Investigator/CPC/CFI/CFS/CHC/CFE/AHFI - Remote Sentara Healthcare IncSenior Fraud and Abuse Investigator/CPC/CFI/CFS/CHC/CFE/AHFI - RemoteVARemote$25.60–$42.67 / hourExperience utilizing data analytics to identify high-risk providers and claims for pre-payment review within a healthcare payer, SIU, Program Integrity, or Payment Integrity environment is strongly preferred. Experience conducting pre-pay investigations, provider risk assessments, data mining, fraud, waste and abuse (FWA) analysis, and proactive identification of billing anomalies and emerging provider trends.
Criminal Investigator (Deputy U.S. Marshal) U.S. Department of JusticeCriminal Investigator (Deputy U.S. Marshal)Alexandria, VA$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.
Affirmative Civil Enforcement (Ace) Investigator CONTACT GOVERNMENT SERVICESAffirmative Civil Enforcement (Ace) InvestigatorArlington, VA$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.
Investigator Assistant Elevance Health IncInvestigator AssistantNorfolk, VAWe 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 Investigator Assistant is responsible for providing administrative support to the investigative unit and performing research on data to assist in identifying cases of potential overpayment or abuse.
Fraud Investigator West Creek Financial IncFraud InvestigatorRichmond, VARemoteFraud Investigators have several tools available to assist in their research, such as application data, internal system of record data, internet search data, and third-party fraud prevention tools. Leverage tools such as application data, internal system of record data, internet search data, and third-party fraud prevention tools to reach accurate investigation conclusions.
DoW SkillBridge Fellowship - Senior Fraud Investigator Navy Federal Credit UnionDoW SkillBridge Fellowship - Senior Fraud InvestigatorWinchester, VA$78,400–$123,200 / yearAccommodations: If you need accommodation or assistance for a qualifying condition to complete the online application (or during any stage of the hiring process), you can contact Navy Federal''s Medical Accommodations team at medicalaccommodations@navyfederal.org or by calling 1-888-503-6013. Help identify indicators involving account takeover, identity theft, first-party fraud, debit card fraud, credit card fraud, loan fraud, and organized fraud schemes.
NewSenior Fraud, Waste and Abuse (FWA) Investigator Pacific SourceSenior Fraud, Waste and Abuse (FWA) InvestigatorRichmond, VirginiaIndependently plan, conduct, and manage prompt, thorough onsite and desk-top investigations of health care claims, Thoroughly document investigative findings and actions to create comprehensive case files in accordance with established policies and procedures. Candidates with an associate's degree and 2 years of relevant experience, or a high school diploma and 4 years of relevant experience, in addition to the required minimum years of work experience will also be considered.