Senior Fire Investigator , Iaai-Cfi EFI GlobalSenior Fire Investigator , Iaai-CfiLos Angeles, CARemote$85,000–$95,000 / 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. PRIMARY PURPOSE: To independently conduct extensive and detailed investigations to determine origin & cause of fires and explosions, primarily involving structures and determining the cause of fires in commercial buildings or residences.
Senior Fire Investigator , IAAI-CFI EFI GlobalSenior Fire Investigator , IAAI-CFILos Angeles, CaliforniaRemote$85,000–$95,000 / 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. PRIMARY PURPOSE : To independently conduct extensive and detailed investigations to determine origin & cause of fires and explosions, primarily involving structures and determining the cause of fires in commercial buildings or residences.
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.
Nurse Investigator The Health PlanNurse InvestigatorCharleston, WVRequired: Registered Nurse; Certified Coder (or eligible within 12 months)or similar certification; Basic knowledge of ICD-9/10, CPT, HCPCS, DRG and/or Rev codes; Proficiency with Office products, including Word and Excel; Critical problem-solving skills and attention to detail. The successful candidate will utilize their unique blend of coding, claims payment, clinical, and payment integrity/investigations expertise to assist the SIU in achieving its mission to prevent, detect, investigate, and resolve healthcare fraud, waste, and abuse.
Surveillance Investigator - San Diego Area A.N. Investigations Inc.Surveillance Investigator - San Diego AreaSan Diego, California$24–$35Position Overview: The Surveillance Investigator is responsible for conducting covert surveillance, documenting claimant activities, obtaining video evidence, and preparing detailed reports for workers’ compensation and insurance-related investigations. We are seeking experienced Surveillance Investigators for part-time, on-call assignments involving workers’ compensation investigations.
Lead SIU Investigator Centene Corporation GroupLead SIU InvestigatorIDRemote$70,100–$126,200 / yearEducation/Experience: Bachelor's Degree in related field; or Associate's degree with 6 years related experience; or High School Diploma/GED with 7 years related experience. Provides direction and guidance to staff who investigate and remediate compliance and fraud, waste, and abuse related matters; while maintaining an investigative workload of moderate to high complexity.
SIU Investigator II Root InsuranceSIU Investigator IIOur perfect candidate understands the auto claims fraud landscape, is financially savvy, articulates both sides of an issue with clarity, digests complex information quickly and accurately, and is comfortable making decisions. Engages in learning opportunities to build knowledge of personal lines claims, court decisions impacting the claims function, current guidelines in claims function, and policy changes and modifications.
NewFraud and Waste Investigator HumanaFraud and Waste InvestigatorOhioRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Senior Litigation Construction Liability Claims Representative TravelersSenior Litigation Construction Liability Claims RepresentativeDiamond Bar, California$94,400–$155,800 / yearDirectly investigates each claim through prompt and strategically-appropriate 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. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
Commercial Lead Security Investigator GEICO GENERAL INSURANCE COMPANYCommercial Lead Security InvestigatorRichardson, TX$69,700–$108,650 / yearAs a Lead Security Investigator on our Commercial Team, you will conduct non-field investigations of suspected Commercial Auto, Commercial Trucking, Multiline, and Auto claims suspected of containing fraud flags and/or other illegal activities against the company. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
NewFraud Investigator Blue Cross and Blue Shield of Kansas CityFraud InvestigatorBaltimore, Missouri3 years' experience conducting healthcare FWA investigations at a health insurer; experience analyzing claims data to identify FWA trends and patterns using tools such as Excel and business intelligence platforms (e.g., Power BI, Business Objects). Knowledge of major BCBSKC business systems (e.g., Facets, ITS Host and Home) and operational processes (e.g., Claims Processing, Pharmacy, Provider Contracting/Relations, Member Services, Customer Service).
Surveillance Investigator - Eastern Panhandle Allied UniversalSurveillance Investigator - Eastern PanhandleTallahassee, FloridaThe 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 - Part Time Allied UniversalSurveillance Investigator - Part TimeOmaha, NebraskaThe 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 - Brooklyn Allied UniversalSurveillance Investigator - BrooklynBrooklyn, 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 .
Surveillance Investigator - Licensed Allied UniversalSurveillance Investigator - LicensedPortland, OregonThe 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 - Peninsula Allied UniversalSurveillance Investigator - PeninsulaRedwood City, California$20–$24 / 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 - South Bay Allied UniversalSurveillance Investigator - South BaySan Jose, California$20–$24 / 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 .
Surveillance Investigator - North Bay Allied UniversalSurveillance Investigator - North BayFairfield, California$20–$24 / 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 - San Francisco Allied UniversalSurveillance Investigator - San FranciscoSan Francisco, California$20–$24 / 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 .