33 Results for

Insurance Investigator Jobs in Massachusetts

Jobs

SIU Fraud Investigator Mass General Brigham

Somerville, Massachusetts

Performs 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.

17 days ago

Investigator, Special Investigations Unit (Meritain Health) CVS Health Corp

$46,988–$122,400 / year

Demonstrated 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.

14 days ago

Surveillance Investigator VRC Investigations

Boston, Massachusetts

VRC 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.

22 days ago

Investigator - Network Services - Full Time CoventBridge Group

Boston, MA

$26–$30 / hour

CoventBridge Integrity Systems delivers investigative services, technology, and expertise that help healthcare and government organizations protect critical programs, strengthen oversight, and address fraud, waste, abuse, and operational risk. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com.

9 days ago

Entry-Level Investigator Ethos Risk Services

Boston, MA

Full time

Our Full-Time Entry-Level Field Investigator position will help launch your career by providing you with an industry leading FULLY PAID Investigator Training Program - no prior experience necessary! Documentation: Finalize case files by submitting case reports and uploading video footage via personal laptop at the end of the day.

30+ days ago

SIU Fraud Investigator Brigham and Women's Hospital

Somerville, MA

$79,560–$115,720.80 / year

16 days ago

Private Investigator - Retired/Former Law Enforcement Lemieux & Associates LLC

Taunton, MA

Part time

We're actively seeking retired and former law enforcement professionals to join our Special Investigations Unit (SIU) as Investigators. Join a team where your background is respected, your voice is heard, and your work continues to make a difference.

30+ days ago

Investigator Ethos Risk Services

Cambridge, MA

Full time

Previous 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.

30+ days ago

AML Investigator Rockland Trust Company

Plymouth, MA

The FIU BSA Investigator will be responsible to perform various risk functions which support compliance with laws, rules and regulations associated with the Bank Secrecy Act, Anti-Money Laundering (AML) regulations, the USA Patriot Act, Customer Identification Program, Beneficial Ownership and Office of Foreign Asset Control (OFAC) requirements. The FIU also develops or assists in developing appropriate policies and procedures, including those designated to assist the business units to know their customers and conduct appropriate due diligence and to prevent, detect and report potentially suspicious activity.

20 days ago

Financial Investigator Contact Government Services LLC

Boston, MA

Establishes 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.

30+ days ago

Affirmative Civil Enforcement ACE Investigator Contact Government Services LLC

Boston, MA

Performs 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.

30+ days ago

Senior Financial Investigator Contact Government Services LLC

Boston, MA

$107,114.45–$141,560.16 / year

Establishes 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.

30+ days ago

Principal Investigator, Quantum Error Correction Riverlane

Boston, MA

Remote

$180,000–$245,000 / year

In this senior role, you will blend hands-on research with technical leadership, setting scientific direction, representing Riverlane to external partners at the highest technical level, and – when opportunities arise – building and mentoring a small research team. Having raised more than $125M in funding to date to accelerate our cutting-edge R&D in quantum error correction (QEC), Riverlane partners with many of the world's leading quantum hardware providers and government agencies to make fault-tolerant quantum computing a reality.

30+ days ago

Clinical Investigator, Breast Oncology The Employee Connect

Boston, Massachusetts

$255,670–$534,220 / year

This role places the investigator at the center of that transformation, with access to cutting-edge laboratory resources, robust biobanking infrastructure, and a deeply engaged patient population eager to participate in clinical research. Boston's life sciences ecosystem provides unparalleled opportunities for collaboration, funding, and innovation, making this an ideal location to build and sustain a high-impact research program.

30+ days ago

Investigator II Point32Health

Canton, Massachusetts

Key Responsibilities/Duties – what you will be doing (top five): Lead moderately complex to complex behavioral health investigations in established and emerging areas of Fraud Waste and Abuse (FWA) involving internal and external research, detailed data analyses, review of medical records, and interviews of members, providers, and other third parties. The Investigator II is an essential team member of the Special Investigation Unit (SIU) responsible for leading complex provider investigations related to fraud, waste, and abuse, and developing action plans to address the investigative findings and prevent future loss.

3 days ago

Healthcare Fraud Investigator Contact Government Services LLC

Boston, MA

$85,000–$105,000 / year

Communication 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.

30+ days ago

SIU Claims Investigator - Spanish Speaker Lemieux & Associates LLC

Taunton, MA

$25–$32 / hour
Part time

Our 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.

30+ days ago

Ind. Accident Investigator II Commonwealth of Massachusetts

Worcester, MA

Accident Investigator II'',''United States-Massachusetts-100 Front Street - Worcester'',''United States-Massachusetts-100 Front Street - Worcester'',''Compliance and Certification'',''Compliance and Certification'',''Department of Workforce Development'',''Department of Workforce Development'',''Full-time'',''Full-time'',''Day'',''Day'',''Apr 24, 2026, 4:13:22 PM'',''Apr 24, 2026, 4:13:22 PM'',''1'',''1'',''101,467.86'',''71,613.10'',''101,467.86'',''Yearly'',''Karen Haynes-Clifton'',''Karen Haynes-Clifton'',''6176265138'',''01-NAGE - Clerical/Administrative'',''01-NAGE - Clerical/Administrative'',''No'',''No'',''No'',''No'',''false'',''1082960'',''1082960'',''true'',''1082960'',''false'',''Submission for the position: Ind. Works with outside agencies relating to the claim Conducts internet and social media research on subjects related to claim Interviews all relevant parties to the claim, in person if possible Attends and participates in conciliations, conferences and court proceedings as needed Conducts physical site visits of claim locations and obtain pictures if relevant.

30+ days ago

Part-time Surveillance Investigator The Robison Group

Boston, MA

Through our operating brands, HVACi, StrikeCheck, National Fire Experts, Donan Engineering, BSC Forensics, Component Testing Laboratories, The Robison Group, VRC Investigations, TechLoss, Mecanica Scientific Services, and HMI we are respected as the industry leader for our scale and our track record of conducting expert, specialized, and accurate investigations. Individuals selected for the position will be expected to perform investigations of workers compensation claims, liability investigations, multi-line insurance claims, criminal and civil background checks, and other investigative tasks.

10 days ago

Surveillance Investigator Allied Universal

Salem, Massachusetts

The 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 .

23 days ago

Utility Vegetation Outage Investigator (Worcester, MA, US, 01605) The Davey Tree Expert Company

Worcester, MA

$22–$26 / hour

Davey Resource Group combines cutting-edge technology with field expertise to support major electric utilities in delivering safe, reliable power while protecting ecosystems. Davey Resource Group, a division of Davey Tree Expert Company, is a national leader in natural resource consulting, environmental services, and utility vegetation management.

27 days ago

Travel Sub-Investigator Care Access

Boston, MA

Remote

$130,000–$165,000 / year

With programs like Future of Medicine , which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers , which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Perform trial procedures as per delegation which can include the following but not limited to: Prescreen study candidates by telephone and review exclusionary conditions or medications prior to scheduling screening appointment.

30+ days ago

Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

$46,988–$122,400 / year

Anticipated 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.

30+ days ago

Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

$43,888–$93,574 / year

Experience with Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research. Bachelor's Degree in Criminal Justice, Healthcare Management, Public Health, Biological Sciences, Data Analytics, or other related field preferred or equivalent experience.

14 days ago

Fraud Investigator Intern Berkshire Bank

Boston, MA

$18–$24.91 / hour

This internship provides exposure to fraud prevention, financial crimes investigations, regulatory compliance and banking operations while developing analytical, investigative and communication skills. Purpose/Objective: The Fraud Investigator Intern supports the Financial Intelligence Unit (FIU), by assisting with the investigation and documentation of suspected fraudulent activity.

16 days ago

Fraud Investigator Berkshire Bank

Boston, MA

$52,000–$90,498 / year

Purpose/Objective: As a member of the Financial Intelligence Unit's Fraud Investigations Team, the incumbent is responsible for handling all aspects of the fraud investigation process - including incident intake, advising on best practices for remediation, case management, and completion of regulatory reports. Key Accountabilities: Investigate fraud referrals/incidents and perform necessary research; efficiently arriving at sound risk-based conclusions in order to minimize fraud losses.

16 days ago

Security Shift Supervisor Pharma Allied Universal

Boston, MA

Driving Positions: must possess a valid Driver's License with at least one year of driving experience, a clean driving record (no major violations within last 36 months, no more than 1 accident in last 24 months, no more than one minor moving violation in last 24 months), a minimum level of insurance as required by Company policy, and the ability to safely operate a vehicle required. Allied 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.

30+ days ago

Manager, SIU Provider Investigations Point32Health, Inc.

Canton, MA

$105,477.36–$158,216.04 / year

Works with investigators to recommend appropriate disposition for investigations, including closure or corrective actions such as provider education, prepayment denial of claims, recovery of overpaid funds, and referrals to appropriate regulatory and law enforcement agencies. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

3 days ago

SIU Claims Director Plymouth Rock Management Company of New Jersey

Boston, MA

$137,000–$200,000 / year

Reporting to the Vice President of Claims, the Director of Special Investigative Unit (SIU) provides strategic leadership for Plymouth Rock's enterprise fraud program across the Personal Lines Property & Casualty Claims organization. Provide oversight of fraud investigations involving Auto Physical Damage, Homeowners, Casualty, PIP, Appraisal, provider fraud, organized fraud rings, staged accidents, and Major Case initiatives.

15 days ago

Director, Special Investigations Unit Mass General Brigham

Somerville, Massachusetts

The SIU team will perform accurate and reliable medical review audits, analyze medical billing and codes, conduct confidential investigations related to compliance and regulatory requirements, documenting the investigation through audit reports for interview and external review which document the findings, and reporting issues of non-compliance in accordance with all laws and regulations. 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.

30+ days ago

SIU Code Auditor Fallon Community Health Plan Inc

Worcester, MA

Brief summary of purpose: The SIU Code Auditor will conduct coding audits of medical records provided by providers to check for missing documentation and other medical documentation for E&M, DME, medical, home health services, and may include some behavioral health care services to identify potential over-payments and suspected fraud waste and abuse. Reporting, education, and regulatory support: Assist with claim denial reporting, respond to regulatory agency complaints, support required fraud reporting to state and federal agencies, and recommend to members, providers, or employee education based on findings.

22 days ago

Manager, SIU Provider Investigations Point32Health

Canton, Massachusetts

6 days ago

Director, Special Investigations Unit Brigham and Women's Hospital

Somerville, MA

Experience: At least 5-7 years of experience in insurance audits, investigations, or a related field required At least 3-5 years of experience in a management role, preferably within healthcare required At least 5-6 years of experience in the Managed Care industry, Medicaid or Medicaid Managed care fraud detection unit preferred At least 6 years of experience in a health care payer setting and/or in a health care fraud control setting highly preferred. The SIU team will perform accurate and reliable medical review audits, analyze medical billing and codes, conduct confidential investigations related to compliance and regulatory requirements, documenting the investigation through audit reports for interview and external review which document the findings, and reporting issues of non-compliance in accordance with all laws and regulations.

30+ days ago

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Insurance Investigator Jobs in Massachusetts

SIU Fraud Investigator Mass General Brigham

Investigator, Special Investigations Unit (Meritain Health) CVS Health Corp

Surveillance Investigator VRC Investigations

Investigator - Network Services - Full Time CoventBridge Group

Entry-Level Investigator Ethos Risk Services

SIU Fraud Investigator Brigham and Women's Hospital

Private Investigator - Retired/Former Law Enforcement Lemieux & Associates LLC

Investigator Ethos Risk Services

AML Investigator Rockland Trust Company

Financial Investigator Contact Government Services LLC

Affirmative Civil Enforcement ACE Investigator Contact Government Services LLC

Senior Financial Investigator Contact Government Services LLC

Principal Investigator, Quantum Error Correction Riverlane

Clinical Investigator, Breast Oncology The Employee Connect

Investigator II Point32Health

Healthcare Fraud Investigator Contact Government Services LLC

SIU Claims Investigator - Spanish Speaker Lemieux & Associates LLC

Ind. Accident Investigator II Commonwealth of Massachusetts

Part-time Surveillance Investigator The Robison Group

Surveillance Investigator Allied Universal

Utility Vegetation Outage Investigator (Worcester, MA, US, 01605) The Davey Tree Expert Company

Travel Sub-Investigator Care Access

Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

Fraud Investigator Intern Berkshire Bank

Fraud Investigator Berkshire Bank

Security Shift Supervisor Pharma Allied Universal

Manager, SIU Provider Investigations Point32Health, Inc.

SIU Claims Director Plymouth Rock Management Company of New Jersey

Director, Special Investigations Unit Mass General Brigham

SIU Code Auditor Fallon Community Health Plan Inc

Manager, SIU Provider Investigations Point32Health

Director, Special Investigations Unit Brigham and Women's Hospital

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