Frasco IncNewSurveillance Investigator Frasco IncSurveillance InvestigatorAlexandria, VA$20–$26 / hourCheck out our YouTube channel to learn more about what a day-in-the-life of a surveillance investigator at Frasco looks like: Frasco, Inc | YouTube Channel . Minimum Auto Insurance Coverage: $100,000 per person, $300,000 per accident bodily injury, and $50,000 property damage.
Lemieux & Associates LLCSIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorWashington, DC$25–$32 / hourOur 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.
Allied UniversalClaims Investigator - Part Time Allied UniversalClaims Investigator - Part TimeCollege Park, Maryland$24–$28 / hour
Integrity Management Services, Inc.NewSIU Healthcare Investigator (Full-time, Remote) Integrity Management Services, Inc.SIU Healthcare Investigator (Full-time, Remote)Alexandria, VARemoteYou will work both independently and with a team of clinical SMEs to analyze data, assess exposure, and manage investigative caseload from identification through to resolution including overpayment recovery, measuring behavior change and completing necessary reporting for FWA recoupments and savings. Perform root cause analysis to inform future algorithmic identification of similar claims or cases and associated savings (i.e., help move identified case types from "pay-and-chase" to preventive edits and pre-payment activity).
Ethos Risk ServicesInvestigator Ethos Risk ServicesInvestigatorWashington, DCPrevious 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.
CoventBridge GroupSurveillance Investigator - Full Time CoventBridge GroupSurveillance Investigator - Full TimeBaltimore, MD$26–$30 / hourCoventBridge Group is the 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. 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 1000 employees and affiliates worldwide.
Engle Martin & Associates, Inc.Senior Property Adjuster (Commercial Property Claims) - Washington, DC Engle Martin & Associates, Inc.Senior Property Adjuster (Commercial Property Claims) - Washington, DCWashington, DCPHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.
Allied UniversalNewSurveillance Investigator Allied UniversalSurveillance InvestigatorManassas, Virginia
U.S. Department of EducationCriminal Investigator, GS-1811-12/13 (MP) U.S. Department of EducationCriminal Investigator, GS-1811-12/13 (MP)Washington, DC$89,508–$138,370 / yearSpecialized Experience for the GS-12 level: One year of specialized experience equivalent to the GS-11 grade level or equivalent public or private sector experience that has equipped you with the particular knowledge, skills, and abilities to perform successfully the following duties or work assignments below: Conducting the full range of criminal investigations of greater than average complexity and importance using accepted methodology and problem-solving techniques. If you are claiming eligibility under the Veterans Employment Opportunities Act (VEOA), you must submit: A copy of your DD-214 that shows active service and character of discharge (member copy 4, Separated Members only) OR a certification of expected discharge or release from active duty under honorable conditions within 120 days from the date of application (Current Active Duty Members only).
U.S. Department of EducationCriminal Investigator (Open Continuous) U.S. Department of EducationCriminal Investigator (Open Continuous)Washington, DC$57,188–$97,087 / yearRelocation expenses reimbursed: No ### Appointment Details Appointment type: Permanent Work schedule: Full-time Service: Competitive Promotion potential: 13 Job family Series: 1811 Criminal Investigation Supervisory status: No Security clearance: Top Secret Drug test: Yes Position sensitivity and risk: Critical-Sensitive CSHigh Risk Trust determination process: Credentialing, Suitability, Fitness, National security, Financial disclosure (Yes - Requires a financial disclosure agreement). Note: If any required coursework is not easily recognizable on transcripts or if you believe a portion of a particular course can be credited toward meeting an educational requirement, you must also provide a memorandum on letterhead from the institutions registrar, dean, or other appropriate official stating the percentage of the course that should be considered to meet the requirement and the equivalent number of units.
Contact Government Services LLCAffirmative Civil Enforcement ACE Investigator Contact Government Services LLCAffirmative Civil Enforcement ACE InvestigatorChantilly, VAPerforms 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.
Blue Cross and Blue Shield AssociationSenior Nurse Investigator (Hybrid) Blue Cross and Blue Shield AssociationSenior Nurse Investigator (Hybrid)Baltimore, MD$67,464–$133,991 / yearCollaborate with investigative teams to correlate review findings with appropriate actions, e.g., provider education through original complex and technical letters, meeting and negotiating with providers, recoveries of monies, recommending network de-selection referrals to State and/or Federal Agencies to effect changes in the providers facilitys practice. When assigned, acts as liaison/consultant to agencies outside the corporation, developing cases in cooperation with Boards of Medicine, local medical societies, and State and/or Federal agencies, including the Office of the Inspector General, Office of Personnel Management, and Federal Bureau of Investigations.
AdNet AccountNet, Inc.EEO Investigator with Telehealth Experience AdNet AccountNet, Inc.EEO Investigator with Telehealth ExperienceMDRemoteWe blend the best in people with the ongoing demands of the workplace by providing high-quality teams and subject matter experts. Strong investigative and analytical skills, with the ability to assess evidence, interview witnesses, and make informed conclusions.
Saks OFF 5THAsset Protection Investigator Saks OFF 5THAsset Protection InvestigatorClarksburg, MD$19–$23.90 / hourThe pay range for this position at commencement of employment is expected to be between $19 - $23.90 /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.
AerotekClaims Reviews Specialist (Workers Compensation) AerotekClaims Reviews Specialist (Workers Compensation)Hanover, MarylandPrepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions. Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek's workers compensation program to ensure the maximum cost containment.
Contact Government Services LLCHealthcare Fraud Investigator Contact Government Services LLCHealthcare Fraud InvestigatorArlington, VA$85,000–$105,000 / yearCommunication skills, Ability to interact professionally and effectively with all levels of staff, including AUSAs, support staff, client agencies, debtors, debtor attorneys, and their staff, court personnel, business executives, witnesses, and the public. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently accurately and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client.
Contact Government Services LLCFinancial Investigator Contact Government Services LLCFinancial InvestigatorBaltimore, MDEstablishes and verifies relationships among all facts and evidence obtained or presented to confirm the authenticity of documents, corroborate witness statements, and otherwise build proof necessary to successful case resolution. Establishes and/or verifies relationships among all facts and evidence obtained or presented to confirm the authenticity of documents, corroborate witness statements, and otherwise build proof necessary for successful litigation.
Contact Government Services LLCSenior Financial Investigator Contact Government Services LLCSenior Financial InvestigatorWashington, DCEstablishes and verifies relationships among all facts and evidence obtained or presented to confirm the authenticity of documents corroborate witness statements and otherwise build proof necessary to successful case resolution. • Establishes and/or verifies relationships among all facts and evidence obtained or presented to confirm the authenticity of documents corroborate witness statements and otherwise build proof necessary for successful litigation.
Integrity Management Services, Inc.Clinical Nurse Coding Auditor (Full-time, Remote) Integrity Management Services, Inc.Clinical Nurse Coding Auditor (Full-time, Remote)Alexandria, VARemoteThis position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified Professional Coder), CIC (Certified Inpatient Coder), CDI (Clinical Documentation Improvement), or a similar credential, through AAPC or AHIMA. In this role, you will leverage your clinical expertise, medical coding proficiency, and auditing skills to identify, monitor, and analyze unusual utilization patterns and potential fraud by healthcare providers.
Lumen Solutions Group, Inc.Risk Adjustment Coding Specialist Lumen Solutions Group, Inc.Risk Adjustment Coding SpecialistWashington, DCRemoteWe provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, Enterprise Transformation.
Lumen Solutions Group IncRisk Adjustment Coding Specialist Lumen Solutions Group IncRisk Adjustment Coding SpecialistWashington, DCRemoteFull timeJob Title: Risk Adjustment Coding Specialist Location: Remote (primarily remote; onsite once a quarter or as needed) Type: Contract to Hire Job Summary: We are seeking experienced and certified Medical Coders to join our Special Investigation Unit (SIU) at CareFirst. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.
ID.meFraud Investigations Manager ID.meFraud Investigations ManagerMcLean, VA$104,000–$152,500 / yearThis leader will operate in a fast-paced, data-rich environment and will serve as a key escalation point for executive communications, subpoenas, RFIs, and other high-sensitivity matters where precision, clarity, and attention to detail are critical. This role is a hands-on people manager who brings prior experience as an individual contributor fraud investigator, combined with proven success building, managing, and developing teams.
US Department of Health and Human ServicesNewResearch Audiologist US Department of Health and Human ServicesResearch AudiologistMontgomery County, MD$121,785–$158,322 / yearThis position is designated as an "emergency essential" position and the selected candidate will be considered an "emergency essential" employee and will be required to be available, ready, willing, and able to report for duty under all circumstances (e.g., inclement weather, government closings and holidays, lapses in appropriations, non-emergency and emergency situations) for operation 24 hours a day and 365 days per year coverage. Documentation must be obtained from a licensed medical professional (e.g., a physician or other medical professional certified by a state, the District of Columbia, or a U.S. territory to practice medicine); a licensed vocational rehabilitation specialist (i.e., state or private); or any Federal agency, state agency, or agency of the District of Columbia or a U.S. territory that issues or provides disability benefits.
Contact Government Services LLCSenior Auditor Contact Government Services LLCSenior AuditorRockville, MD$80,000–$150,000 / yearAnalyze and calculate ability to pay settlements and judgments, including analyzing debt covenants, borrowing capacity, adjusted earnings, and earnings per share financial ratios, accounts receivable and accounts payable aging schedules, tax considerations, assessing collectability, and developing payment terms and schedules. CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-pay analyses, which serve a significant role in determinations regarding investigations, prosecutions, settlements, and recovery in these matters, which can be voluminous and complex.
TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Baltimore, MDRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.