SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorWashington, DC$25–$32 / hourFull 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.
SIU Investigator - Northern VA and MD Allied UniversalSIU Investigator - Northern VA and MDMaryland, MD$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 Investigator Allied UniversalSIU InvestigatorSilver Spring, MD$27–$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.
Investigator 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.
NewSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)MD$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.
Surveillance Investigator Allied UniversalSurveillance InvestigatorManassas, Virginia$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. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
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.
Fire Investigator EFI GlobalFire InvestigatorBaltimore, MarylandRemote$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.
NewContractual Insurance Investigator II/ III State of MarylandContractual Insurance Investigator II/ IIIAnnapolis, MD$30.28–$32.13 / hourThe Maryland Insurance Administration (MIA) is an independent State agency that regulates Marylandâs $46 billion insurance industry and protects consumers by monitoring and enforcing insurersâ and insurance professionalsâ compliance with State law. Staff members are subject matter experts who serve as a resource for lawmakers, consumers, and other public and private entities.Â. The Property and Casualty Complaints Insurance Investigator assists the citizens of Maryland with their written or verbal complaints and inquiries to ensure that insurers and their representatives, premium finance companies, motor clubs and all others over which we have jurisdiction have complied with the applicable laws and the relevant terms of insurance policies when settling claims, canceling or non-renewing insurance policies, or taking any other action with respect to the complainants.
Investigator U.S. Department of JusticeInvestigatorWashington, DC$106,437–$138,370 / yearMINIMUM QUALIFICATIONS: To be considered minimally qualified for this position, you must demonstrate that you have the required specialized experience and/or education for the respective grade level in which you are applying: To qualify at the GS-13 level, you must possess: Specialized Experience: At least one year of specialized experience equivalent to the GS-12 level in the Federal service performing (obtained in either the public or private sectors) (4) of the (5) duties listed below: Applying laws, regulations, policies, and procedures sufficient to plan or conduct health program claims investigations or interviews; Leading or directing investigative teams to ensure compliance with applicable regulations; Providing analytical advice with respect to investigations and evidence to identify potential fraudulent behavior; Coordinating surveillance of suspects with appropriate law enforcement/investigative agencies; Utilizing office automation tools and applications for litigation support and trial presentation programs, to capture, review or organize data to present documentary evidence for use by attorneys in court. Veterans Preference Documentation, if applicable: In order to verify your Veterans Preference entitlement, you must submit a copy of the Member Copy 4 of your DD-214 (Certificate of Release or Discharge from Active Duty); or if you are a current Active Duty member you must submit a certification on appropriate military branch letterhead that indicates:1) your service dates, 2) expected discharge or release date from active duty with a release/discharge date no later than 120 days from the closing date of this announcement, and 3) the character of service (e.g., Honorable); or other official documentation (e.g., documentation of receipt of a campaign badge or expeditionary medal) that shows your military service was performed under honorable conditions.
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.
Supervisory Criminal Investigator (SAC) U.S. Department of JusticeSupervisory Criminal Investigator (SAC)Washington, DC$169,279–$197,200 / yearIf you are selected as the Supervisory Criminal Investigator (Special Agent in Charge), your responsibilities would include, but would not be limited to: Oversees all criminal and administrative investigations related to all assigned components within the Department of Justice to include the Federal Bureau of Investigation (FBI), the Drug Enforcement Administration (DEA), and the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). Examples of specialized experience include such duties as: supervising a team engaged in conducting comprehensive investigations encompassing allegations of criminal misconduct, serious administrative infractions or integrity violations involving individuals, groups, or large organizations.
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.
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.
Special Investigator AmeriHealth CaritasSpecial InvestigatorWashington, DCRemote$80,400–$109,500 / 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).
Criminal Investigator U.S. Department of Homeland SecurityCriminal InvestigatorWashington, DC$65,562–$121,478 / yearEmployees who transfer to TSA from an agency that allows employees to maintain an annual leave balance higher than the maximum accumulation for the appointed position will have their leave ceiling set to the maximum accumulation for the appointed position (e.g., United States duty location - 240 hours, foreign duty location - 360 hours, or TSES position - 720 hours). Applicants must successfully complete the Criminal Investigator Training Program (CITP) at the Federal Law Enforcement Training Center (FLETC) or other equivalent training (e.g., FBI, DEA, US Postal Inspection Service, Air Force OSI, Army CID, NCIS and DCIS) for the position at the G band level and successfully completed the Criminal Investigator Training Program (CITP) or other equivalent training for the position at the H/I levels.
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.
Affirmative Civil Enforcement (Ace) Investigator CONTACT GOVERNMENT SERVICESAffirmative Civil Enforcement (Ace) InvestigatorRockville, MD$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 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).
CRIMINAL INVESTIGATOR U.S. Department of Veterans AffairsCRIMINAL INVESTIGATORWashington, DC$63,780–$97,087 / yearSpecial Instructions for Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. All candidates who are: Current or former federal employees qualifying as Status Candidates, Federal employees currently serving on a VRA, VEOA eligibles, CTAP/ICTAP eligibles, eligible for special hiring authorities (e.g., the Schedule A appointment for persons with disabilities, or covered by an Interchange Agreement), or VRA eligibles or Land Management employees eligible under Public Law 114-47.