Registered Nurse - Nursing Home Surveyor/Complaint Investigator Greenlife Healthcare StaffingRegistered Nurse - Nursing Home Surveyor/Complaint InvestigatorNew York, NYWe are seeking a dedicated and experienced Registered Nurse - Nursing Home Surveyor/Complaint Investigator to join our team in New York City, NY (Bronx, Kings, Richmond, Manhattan, and Queens). This role is a temporary-to-permanent position that involves conducting surveys, complaint investigations, and surveillance activities at nursing homes to ensure compliance with Federal and State regulations.
NewInsurance Defense Attorney JobotInsurance Defense AttorneyDallas, TX$120,000–$165,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. We are seeking a skilled Personal Injury Defense Attorney to join our team and handle a wide range of litigation matters, including auto and trucking accidents, premises liability, and general liability cases.
Registered Dietitian - Nursing Home Surveyor/Complaint Investigator Greenlife Healthcare StaffingRegistered Dietitian - Nursing Home Surveyor/Complaint InvestigatorSyracuse, NYExcellent communication (written and verbal) skills with the ability to relate effectively to providers, physicians, senior medical and administrative personnel, and residents/patients. Impactful Work: Contribute directly to improving the quality of nutritional care and resident outcomes in long-term care facilities.
Licensed Master Social Worker - Nursing Home Surveyor/Complaint Investigator Greenlife Healthcare StaffingLicensed Master Social Worker - Nursing Home Surveyor/Complaint InvestigatorSyracuse, NYIn this role you will participate as a member of an interdisciplinary survey/investigation team to review allegations of abuse and neglect, perform surveillance activities/tasks at nursing homes (long term care)/Transitional Care Units (TCUs), and Adult Day Health Care Programs (ADHCP) to determine compliance with the requirements of participation; prepare written reports of investigative findings and prepare Statement of Deficiencies (SOD) within required time frame, using Principles of Documentation; participate in emergency surveys at Skilled Nursing Facilities (SNF's); participate in State monitoring during Immediate Jeopardy situations; as well as other duties. Soft Skills: Strong interpersonal skills; ability to facilitate positive outcomes in adverse situations; excellent written and verbal communication; superior investigative and analytical skills; ability to conduct interviews effectively; ability to work independently and collaboratively.
Corporate Fraud Investigator Mountain West BankCorporate Fraud InvestigatorSpokane, WAFull timeThis role involves handling cases related to electronic banking fraud (including Zelle), new account abuse, deposit fraud, check forgery, elder abuse, debit and credit card fraud, suspected money laundering, check kiting, identity theft, internal fraud, loan fraud, and other complex schemes. Conduct routine investigations into suspected fraud including identity theft, account abuse, check fraud, elder abuse, debit/credit card fraud, loan fraud, electronic banking fraud (e.g., Zelle), internal fraud, loan fraud, and others.
Experienced Background Investigator - Elk, WA Peraton IncExperienced Background Investigator - Elk, WAElk, WAFull timeThe Investigator will be responsible for the following but not limited to: Travel daily when conducting in person background investigations for the purpose of determining employment suitability of persons who require access to sensitive or classified U.S. Government information. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies.
Insurance Investigator Commonwealth of VirginiaInsurance InvestigatorRichmond, VA$60,278–$75,000 / yearThrough specialized investigations and audits, an Insurance Investigator determines the validity of consumer filed complaints against life, health, and annuity agents and agencies. Conduct thorough searches using investigative databases, internal resources, internet resources, and public records to locate parties and collect information.
Insurance Investigator - Cooperstown, NY UnitedHealth Group IncInsurance Investigator - Cooperstown, NYCooperstown, NY$18–$32 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Individuals in this role serve as a liaison between medical staff, patient financial services, insurance payers, patients, family members and other team members to ensure excellent patient care.
Welfare Fraud Investigator (Entry/Journey) DOQ Solano County CailforniaWelfare Fraud Investigator (Entry/Journey) DOQFairfield, CA$97,136–$138,902.40 / yearThe Welfare Fraud Investigator (Journey) will conduct routine and complex investigations, regarding public assistance eligibility, theft, and fraud, as well as other investigations such as threats against department employees and theft of and damage to public property; prepares cases substantiated for administrative and/or formal legal action; testifies in both judicial and non-judicial proceedings; and performs related duties as required. Note: Incumbents hold peace officer powers pursuant to Section 830.35 of the California Penal Code, however, this is not considered an active law enforcement classification for such personnel administrative matters as retirement, industrial or workers compensation.
Welfare Fraud Investigator (Supervisor) Solano County CailforniaWelfare Fraud Investigator (Supervisor)Fairfield, CA$138,777.60–$168,688 / yearI understand that I must attach or submit copy of my degree or unofficial/official transcripts in Criminal Justice, Criminology, Law Enforcement, Police Science, or a closely related field by application review deadline in order to be considered for this position (unless you have a California Intermediate Post Certificate that can be substituted for the education requirement). Our investigators conduct thorough criminal and administrative investigations, verify eligibility information, recover public funds through overpayment collections and court-ordered restitution, and work closely with local, state, and federal partners to uphold the integrity of public assistance programs.
Fraud Investigator I Space Coast Credit UnionFraud Investigator IMIRAMAR, FL$28.13–$29.79 / hourThis role partners with law enforcement and internal teams, including Legal, Compliance, and Operations, to identify fraudulent activity, mitigate risk, and strengthen fraud detection and prevention processes. Stays current with fraud trends in the market by monitoring data from the Fraud Analysts and attending meetings/or conferences in order to prevent fraud losses to the organization and our membership.
Clinical Fraud Investigator II Elevance HealthClinical Fraud Investigator IIAtlanta, GeorgiaRequires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or any combination of education and experience, which would provide an equivalent background. Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.
Senior Civil Health Care Fraud Investigator Contact Government Services LLCSenior Civil Health Care Fraud InvestigatorHarrisburg, PA$100,000–$200,000 / yearFor the past nine years we've been growing our government-contracting portfolio, and along the way we've created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come.
Healthcare Fraud Investigator Contact Government Services LLCHealthcare Fraud InvestigatorOxford, MSThe 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. Initiates contacts with federal, state, and local officials, and other organizations and individuals related to the subject of investigation, for the purpose of gathering facts, obtaining statements, learning sequences of events, obtaining explanations and otherwise advancing investigative objectives.
Healthcare Fraud Investigator at Integrity Advantage (Remote) HireAlignedHealthcare Fraud Investigator at Integrity Advantage (Remote)Remote, OREGONRemoteUtilize clients fraud detection solution to identify post-payment or pre-payment opportunities for investigation as well as other applications to perform data mining or track investigative results. Integrity Advantage is a small woman owned business serving health payers and other entities challenged with the detection, investigation and prevention of healthcare fraud, waste and abuse (FWA).
NewFraud Investigator City of FlintFraud InvestigatorFlint, MI$35.60–$39.47 / hourUnder general direction, performs advanced professional investigative work involving allegations of employee misconduct, fraud, abuse, theft, ethics violations, misuse of City assets, procurement irregularities, payroll fraud, workers compensation fraud, residency violations, conflicts of interest, and other violations of City policies, collective bargaining agreements, and applicable federal, state, and local laws. Do you have three (3) to five (5) years of progressively responsible professional experience conducting fraud investigations, administrative investigations, internal investigations, compliance investigations, internal auditing, human resources investigations, law enforcement investigations, or other closely related investigative work?
Claims Fraud Investigator Zurich Insurance Group LtdClaims Fraud InvestigatorAZRemoteOur hybrid work model is thoughtfully designed around employee needs offering autonomy to complete focused work from a preferred location, while still supporting meaningful in-person collaboration when it adds value. Under general direction and within defined authority limits, this role is responsible for conducting insurance fraud investigations involving complex schemes, multi claim patterns, organized activity, and non medical major case work.
Fraud Investigator City of Portsmouth VAFraud InvestigatorPortsmouth, VA$53,765.84–$69,216.92 / yearInvestigates referrals to determine withheld, altered or misrepresented information; receives and logs referrals from multiple sources; contacts employers, schools and other sources; interviews clients; prepares and forwards findings affecting ongoing and pending eligibility to prevent incorrect program payments; calculates incorrect program payments and obtains repayment agreements; and prepares and forwards findings on non-IPVs to workers supervisor. Requires the ability to analyze, reconcile and prepare reports, budget expenditures, work orders, time cards, incident reports, billing invoices and other required documentation using prescribed formats and conforming to all rules of punctuation, grammar, diction and style.
Fraud Investigator - Wage - Multiple Vacancies State of MaineFraud Investigator - Wage - Multiple VacanciesBangor, Maine$22.91–$31.97 / hourNo matter where you work across Maine state government, you find employees who embody our state motto-"Dirigo" or "I lead"-as they provide essential services to Mainers every day. A Baccalaureate Degree in Criminal Justice, Law, Business or Public Administration, or related field -AND- one year experience in criminal investigation, law enforcement, forensic accounting, auditing, or related field.
Clinical Fraud Investigator II Elevance Health IncClinical Fraud Investigator IIWilmington, DEMinimum Requirements: Requires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or any combination of education and experience, which would provide an equivalent background. Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.
Fraud Investigator German American Bancorp, Inc.Fraud InvestigatorJasper, INIn this role, you'll lead investigations into suspected fraud, analyze transaction activity and digital banking data, and coordinate with internal teams, financial institutions, and law enforcement when necessary. Overview: Financial fraud investigations require experienced professionals who can connect the dots, analyze complex activity, and work with partners across the financial system to resolve cases.
FWA Special Investigations Unit SIU Investigator SummaCare IncFWA Special Investigations Unit SIU InvestigatorAkron, OH$28.10–$42.15 / hour3) Maintains working knowledge of relative enterprise and local information systems, databases, data schemas, software packages, and business operations to facilitate precise, reliable and accurate fulfillment of information needs related to corporate operations. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS).
NewSurveillance Investigator Frasco IncSurveillance InvestigatorBirmingham, AL$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.
SIU Investigator Allied UniversalSIU InvestigatorGeneva, NY$27–$32 / hourAllied Universal SkillBridge Program Allied Universal partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits. Dog Detection Spotlight - Kyle and Maverick As part of Allied Universal Enhanced Protection Services' fleet of detection canine teams, Kyle and Maverick are trained and certified to screen cargo under the U.S. Transportation Security Administration's (TSA) Third-Party Canine (3PK9) Program.
Clinical Special Investigations Unit Investigator- Health Plan Parkland HealthClinical Special Investigations Unit Investigator- Health PlanMust be currently certified and in good standing or obtain certification within twelve (12) months of hire with one of the following: Health Care Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI), Association of Certified Fraud Examiners (CFE), or National Health Care Anti-Fraud Association (NHCAA). Responds to Requests for Information (RFIs) from National Benefit Integrity MEDIC, U.S. Office of Personnel Management Office of the Inspector General (OPM OIG), State Departments of Insurance (DOI), and other law enforcement agencies, as appropriate.
Investigator Assistant State of OhioInvestigator AssistantCleveland, OHLausche Building LSCH 615 West Superior Avenue Cleveland 44113-1879 Lausche Building615 West Superior AvenueCleveland44113-1879United States of America-OHIO-Cuyahoga County-ClevelandUnited States of America-OHIO-Cuyahoga County-Cleveland21.93hour21.93hourFull-timeFull-timeSEE 134569true134569falseSubmission for the position Investigator Assistant - Job Number 250008DCfalse134569falsetrueInvestigator Assistant250008DCLottery CommissionLottery CommissionOhio Lottery Commission Office of Human Resources careerslottery.ohio.govOhio
SIU Fraud Investigator Mass General BrighamSIU Fraud InvestigatorSomerville, MassachusettsPerforms case research to include the review, interpretation, and application of payment policies, medical policies, provider manuals, benefits documents, national or local coverage determinations, and other applicable clinical practice parameters, regulations, or guidance pertaining to the submission of claims to health insurance plans. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
INVESTIGATOR V (OFFICE OF INSPECTOR GENERAL) - DOWNTOWN State of HawaiiINVESTIGATOR V (OFFICE OF INSPECTOR GENERAL) - DOWNTOWNHonolulu, HI$6,221–$7,568The Investigator V level plans, organizes, directs and coordinates the activities of an investigative agency concerned with civil, administrative and/or criminal investigations falling within its respective jurisdiction, where violations investigated are related to a specific program area, e.g., welfare fraud, etc., OR conducts civil, administrative and/or criminal investigations falling within a variety of jurisdictions, such as the Executive, Legislative or Judicial Branches, State departments or agencies, county and federal governments and regulatory boards and commissions, where violations or circumstances investigated are related to a broad variety of program areas, and are not limited to a specific program area (welfare fraud, controlled substances, etc.), like that of lower investigator levels; and performs other related duties as assigned. Selective Certification Requirement (Criminal and/or Administrative Investigations Experience): In order to effectively perform these duties and responsibilities, applicants must possess demonstrated knowledge of interviewing and interrogation techniques; proper investigative report writing techniques, rules of legal evidence; search and seizure laws; laws of arrest; techniques of and equipment used in surveillance; proper use of force, including deadly force; and the Hawaii Penal Code.
INVESTIGATOR V (CRIMINAL INVESTIGATIONS) - OAHU State of HawaiiINVESTIGATOR V (CRIMINAL INVESTIGATIONS) - OAHUHI$6,221–$7,568The Investigator V level plans, organizes, directs and coordinates the activities of an investigative agency concerned with civil, administrative and/or criminal investigations falling within its respective jurisdiction, where violations investigated are related to a specific program area, e.g., welfare fraud, etc., OR conducts civil, administrative and/or criminal investigations falling within a variety of jurisdictions, such as the Executive, Legislative or Judicial Branches, State departments or agencies, county and federal governments and regulatory boards and commissions, where violations or circumstances investigated are related to a broad variety of program areas, and are not limited to a specific program area (welfare fraud, controlled substances, etc.), like that of lower investigator levels; and performs other related duties as assigned. Investigations include allegations of improper and unethical conduct by State employees, appointed officials, and public officers; tort, damage, flood and injury claims; traffic accidents or other accidents occurring on State-owned property; organized crime activities; corruption by public employees and officials; assaults, stabbings, and murder in State correctional facilities; and any other situation where enforcement and investigative assistance is requested.
INVESTIGATOR V - DEPARTMENT OF COMMERCE & CONSUMER AFFAIRS - LIHUE, KAUAI State of HawaiiINVESTIGATOR V - DEPARTMENT OF COMMERCE & CONSUMER AFFAIRS - LIHUE, KAUAILihue, HI$6,221–$7,568The Investigator V level plans, organizes, directs and coordinates the activities of an investigative agency concerned with civil, administrative and/or criminal investigations falling within its respective jurisdiction, where violations investigated are related to a specific program area, e.g., welfare fraud, etc., OR conducts civil, administrative and/or criminal investigations falling within a variety of jurisdictions, such as the Executive, Legislative or Judicial Branches, State departments or agencies, county and federal governments and regulatory boards and commissions, where violations or circumstances investigated are related to a broad variety of program areas, and are not limited to a specific program area (welfare fraud, controlled substances, etc.), like that of lower investigator levels; and performs other related duties as assigned. The Investigator IV performs and/or supervises investigations involving suspected or actual violations of civil, administrative and/or criminal laws, rules, regulations or other legal requirements within an agencys jurisdiction; determines case approach and gathers supporting evidence or information; prepares reports; and performs other related duties as assigned.
INVESTIGATOR V (HOMELAND SECURITY) - OAHU State of HawaiiINVESTIGATOR V (HOMELAND SECURITY) - OAHUHonolulu, HI$6,221–$7,568The Investigator V level plans, organizes, directs and coordinates the activities of an investigative agency concerned with civil, administrative and/or criminal investigations falling within its respective jurisdiction, where violations investigated are related to a specific program area, e.g., welfare fraud, etc., OR conducts civil, administrative and/or criminal investigations falling within a variety of jurisdictions, such as the Executive, Legislative or Judicial Branches, State departments or agencies, county and federal governments and regulatory boards and commissions, where violations or circumstances investigated are related to a broad variety of program areas, and are not limited to a specific program area (welfare fraud, controlled substances, etc.), like that of lower investigator levels; and performs other related duties as assigned. Selective Certification Requirement (Homeland Security Investigations Experience): In order to effectively perform the duties and responsibilities of these positions, applicants must possess demonstrated knowledge of the intelligence cycle/process; intelligence-led policing principles and practices related to homeland security threats and criminal activities; criminal and intelligence investigations management; and the jurisdictions and functions of various governmental agencies and departments.
INVESTIGATOR V (HEMP INVESTIGATIONS) - DOWNTOWN, OAHU State of HawaiiINVESTIGATOR V (HEMP INVESTIGATIONS) - DOWNTOWN, OAHUHonolulu, HI$6,221–$7,568The Investigator V level plans, organizes, directs and coordinates the activities of an investigative agency concerned with civil, administrative and/or criminal investigations falling within its respective jurisdiction, where violations investigated are related to a specific program area, e.g., welfare fraud, etc., OR conducts civil, administrative and/or criminal investigations falling within a variety of jurisdictions, such as the Executive, Legislative or Judicial Branches, State departments or agencies, county and federal governments and regulatory boards and commissions, where violations or circumstances investigated are related to a broad variety of program areas, and are not limited to a specific program area (welfare fraud, controlled substances, etc.), like that of lower investigator levels; and performs other related duties as assigned. Selective Certification Requirement (Hemp Investigations Experience): In order to successfully perform the duties and responsibilities of these positions, applicants must possess knowledge of interviewing and interrogation techniques, proper investigative report writing techniques; rules of legal evidence; search and seizure laws; laws of arrest; techniques of and equipment used in surveillance; proper use of force, including deadly force; and Hawaii Penal Code.
Senior Investigator EmblemHealth IncSenior InvestigatorNew York, NY$68,040–$118,800 / yearEstablish and maintain relationships with law enforcement (HHS-OIG, FBI), regulatory agencies (i.e DFS, MEDIC, OMIG, MFCU, NYS OAG), and with industry peers. Develop and maintain relationships with law enforcement (HHS-OIG, FBI, DOJ), regulatory agencies (DFS, MEDIC, OMIG, MFCU) and with industry peers.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS HealthSenior Investigator, Special Investigations Unit (Aetna SIU)Work At Home, WA$46,988–$112,200 / yearPreferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE + Knowledge of CVS/Aetna's policies and procedures + Understanding of self-funded insurance plan operations + Strong communication and customer service skills and the ability to effectively interact with Aetna's customers + Resident of North Carolina **Education** + Bachelor's degree preferred or equivalent work experience. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $112,200.00 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.
Clinical Special Investigations Unit Investigator- Health Plan Parkland HospitalClinical Special Investigations Unit Investigator- Health PlanTXMust be currently certified and in good standing or obtain certification within twelve (12) months of hire with one of the following: Health Care Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI), Association of Certified Fraud Examiners (CFE), or National Health Care Anti-Fraud Association (NHCAA). Responds to Requests for Information (RFIs) from National Benefit Integrity MEDIC, U.S. Office of Personnel Management Office of the Inspector General (OPM OIG), State Departments of Insurance (DOI), and other law enforcement agencies, as appropriate.
Senior Fire Investigator, IAAI-CFI EFI Global IncSenior Fire Investigator, IAAI-CFIRichardson, TXRemoteOver 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. Possesses necessary knowledge and expertise required to conduct thorough inspection of available public records including land deeds, mortgages, liens, suits, judgments, marriage and divorce records, etc.
Surveillance Investigator VRC InvestigationsSurveillance InvestigatorBoston, MassachusettsVRC provides their investigators with necessary equipment and comparable pay, to include drive time, above normal commute mileage reimbursement, company paid licensing fees in most states and allowance for non-reimbursed business expenses. We currently have career opportunities for experienced, self-determined, and highly motivated SURVEILLANCE INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud.
Surveillance Investigator (Part-Time) VRC InvestigationsSurveillance Investigator (Part-Time)Omaha, NebraskaVRC provides their investigators with necessary equipment and comparable pay, to include drive time, above normal commute mileage reimbursement, company paid licensing fees in most states and allowance for non-reimbursed business expenses. We currently have career opportunities for experienced, self-determined, and highly motivated SURVEILLANCE INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud.
Part-Time Surveillance Investigator VRC InvestigationsPart-Time Surveillance InvestigatorColumbia, South CarolinaVRC provides their investigators with necessary equipment and comparable pay, to include drive time, above normal commute mileage reimbursement, company paid licensing fees in most states and allowance for non-reimbursed business expenses. We currently have career opportunities for experienced, self-determined, and highly motivated SURVEILLANCE INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud.
Corporate Fraud Investigator Glacier BankCorporate Fraud InvestigatorHelena, MTThis role involves handling cases related to electronic banking fraud (including Zelle), new account abuse, deposit fraud, check forgery, elder abuse, debit and credit card fraud, suspected money laundering, check kiting, identity theft, internal fraud, loan fraud, and other complex schemes. WA Applicants ONLY range:Spokane $32.65 to $48.97 an hourWenatchee $33.10 to $49.66 an hourDescription- Conduct routine investigations into suspected fraud including identity theft, account abuse, check fraud, elder abuse, debit/credit card fraud, loan fraud, electronic banking fraud (e.g., Zelle), internal fraud, loan fraud, and others.
Field SIU Investigator - Tampa Kemper CorpField SIU Investigator - TampaTampa, FLFraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designations are preferred. Investigates files by using appropriate field, computer and telephone investigative techniques and provides appropriate documentation of actions in a thorough timely manner.
Member Account Protection Investigator StratAcuity Staffing Partners IncMember Account Protection InvestigatorAnaheim, CA$43–$54 / hourIn terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
Medical Review Associate Investigator HealthPartners InstituteMedical Review Associate InvestigatorBloomington, MNPrimary responsibilities include performing structured intake analysis, conducting preliminary review of claims and provider data, assessing documentation and medical record completeness, identifying investigative risks or trends, and supporting prioritization of cases based on defined FWA indicators. The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and supports the identification, assessment, and preliminary analysis of potential Fraud, Waste, and Abuse (FWA) concerns across Medicaid, Medicare, and Commercial (fully insured and self‑funded) lines of business.
Sr. Investigator (Full-time, Remote) Integrity Management Services, Inc.Sr. Investigator (Full-time, Remote)Alexandria, VARemoteIntegrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. In this role, the Senior Investigator will conduct investigations that support healthcare program integrity initiatives by identifying potential fraud, waste, and abuse (FWA), analyzing complex information, and developing investigative findings.
Senior Investigator (Healthcare FWA) CotivitiSenior Investigator (Healthcare FWA)RemoteRemote$70,000–$90,000 / yearFull timePreferred certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Specialist (CFS), Certified Fraud Examiner (CFE), Certified Forensic Interviewer (CFI), or. Overview: As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required).
INVESTIGATOR State Of CaliforniaINVESTIGATORSanta Clara, CA$6,339–$10,609 / yearIncumbents may work alone, with a team, or as a lead criminal investigator assigned to conduct investigations of criminal enterprises and profiteering and assist in the prosecution of cases involving these groups in both State and Federal courts; and conduct investigations involving a broad range of felony violations, both State and Federal judicial systems. In addition to the regular salary, this classification is eligible for the following pay differentials: Recruitment & Retention - $200/month (For Investigators assigned to offices in the following counties: Los Angeles County, Santa Clara County, Solano County).
Consumer Transaction Monitoring Investigator Guidehouse IncConsumer Transaction Monitoring InvestigatorSan Antonio, TXEnd to end understanding of Transaction Monitoring/ KYC/ Screening/ Fraud Operations/Jurisdiction specific SAR filing/Narrative from documentary and non-documentary verification and as per relevant policy, nature of business, source of wealth/funds, and customer screening against the watchlist of Sanctions, PEP, and adverse media. Ability to conduct detailed investigations using vendors and open sources to remediate compliance alerts and to independently research, analyze, and recommend solutions to close open items and discrepancies.
Desktop Investigator VRCDesktop InvestigatorDenton, TexasCompensation: *]:pointer-events-auto [content-visibility:auto] supports-[content-visibility:auto]:[contain-intrinsic-size:auto_100lvh] R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto"> Accepted candidates will be paid a competitive hourly rate of $18–$20 per hour, commensurate with relevant experience. The desktop investigator will complete tasks with other team members under management supervision, and when needed, will have the opportunity to cross train in other departments/divisions.
Investigator State of IowaInvestigatorDes Moines, IA$63,585.60–$98,633.60 / yearAnalyze insurance company and producer conduct for adherence to critical statutes, including the Insurance Trade Practices Act (Iowa Code Chapter 507B), the Insurance Producer Law (Iowa Code Chapter 522B), Licensing of Adjuster (Iowa Code Chapter 522C), Licensing of Appraisers and Umpires (Iowa Code Chapter 522F) and Uniform Securities Act (Iowa Code Chapter 502). Business management and administration including: budget administration and analysis, regulatory and legal compliance, quality assurance, and customer service administration., where thirty semester hours of accredited college or university course work in any field equals one year of full-time experience?.
AGO Senior Investigator/Analyst | Medicaid Fraud & Abuse Division | Seattle State of WashingtonAGO Senior Investigator/Analyst | Medicaid Fraud & Abuse Division | SeattleSeattle, WA$6,870–$9,246The incumbent develops sources of information relating to Medicaid fraud and abuse and neglect in residential facilities; executes search warrants; collects, preserves and handles evidence in accordance with established rules of evidence; conducts surveillance; conducts criminal and civil interviews; prepares written reports, affidavits and other investigative documents; serves as a subject matter expert in civil and criminal healthcare fraud investigations. With the goal of employee health and wellness, we also offer: Flexible schedules and part-time/hybrid telework options; A Wellness Program, an Infants in the Workplace Program, and the Employee Assistance Program, which provides counseling, webinar, and other cost-free support resources; Numerous employee-driven affinity groups to foster community and connection, including Bereavement, Elder Care, Parenting, POC, LGBTQ+, Veterans and more.