Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)MD$46,988–$122,400 / yearAnticipated 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.
Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)MD$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. 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.
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 .
Criminal Investigator (Deputy U.S. Marshal) U.S. Department of JusticeCriminal Investigator (Deputy U.S. Marshal)Baltimore, MD$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 Services LLCAffirmative Civil Enforcement ACE InvestigatorBaltimore, MDPerforms 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.
Auditor/Investigator II Qlarant Quality Solutions IncAuditor/Investigator IIMDCollects 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.
General Liability Claim Representative The Travelers Companies IncGeneral Liability Claim RepresentativeHunt Valley, MD$67,000–$110,600 / yearInvestigates 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.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)MD$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
General Liability Property Damage Adjuster - Washington DC/Baltimore Engle Martin & Associates, Inc.General Liability Property Damage Adjuster - Washington DC/BaltimoreMDYour EMpact: Determine appropriate methods and extent of needed investigation for all assigned claims, including conducting investigations through field visits and phone contact; obtaining contracts, job files, and appraisals; conducting insured, witness, and claimant interviews and/or statements, complete site inspections; scope, measure and write estimates, and using other fact-finding methods to evaluate liability, damages, and proper coverage. Investigate insurance claims in a variety of settings including, but not limited to: retail establishments, office buildings, residences, condominiums, apartments, hotels, corporate facilities, governmental facilities, schools, clinics, or hospitals; assess loss or damage resulting from various events including, but not limited to, inclement or catastrophic weather, construction defect, and fire.
NewBodily Injury Adjuster - Represented, Moderate/Complex - MD, VA, DC, DE, WV (Remote) Allstate Insurance CompanyBodily Injury Adjuster - Represented, Moderate/Complex - MD, VA, DC, DE, WV (Remote)MDRemote$53,500–$84,625 / yearYou'll wear a few hats to fill a few roles throughout your day that all require a level of experience: The Customer Service Expert -you'll live into Allstate's Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each casualty claim. As a Represented Bodily Injury Adjuster, your main focus will be investigating automobile accidents involving single or multiple vehicles, which result in property damage and/or bodily injury with attorney/litigation involved.