Investigator Ethos Risk ServicesInvestigatorLouisville, KYFull timePrevious 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.
NewSIU Investigator Allied UniversalSIU InvestigatorLouisville, KYAcquire 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.
Surveillance Investigator Allied UniversalSurveillance InvestigatorLouisville, KentuckyThe 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 .
Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)KY$46,988–$122,400 / yearDemonstrated 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.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)KY$46,988–$122,400 / yearAnticipated 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.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)KY$43,888–$93,574 / yearExperience 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.
Carelon Coordination of Benefits (COB) - Investigator II Elevance HealthCarelon Coordination of Benefits (COB) - Investigator IILouisville, KentuckyThe Carelon COB Investigator II ( Financial Operations Recovery Specialist II) is tasked with conducting thorough investigations into potential other coverages, accurately determining primacy, and ensuring seamless coordination of benefits (COB) across multiple vendor clients, employer groups, and government and specialty lines of business. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Part-Time Surveillance Investigator The Robison GroupPart-Time Surveillance InvestigatorLouisville, KentuckyThrough 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.
Diversion Control Investigator Cencora IncDiversion Control InvestigatorKY$43,300–$79,310 / yearExperience and Educational Requirements: Requires broad training in fields such as criminal justice, business administration, accountancy, sales, marketing, computer sciences or similar vocations generally obtained through completion of a four year degree program or equivalent combination of experience and education. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave.
Senior Compliance Investigator Centene Corporation GroupSenior Compliance InvestigatorKY$70,100–$126,200 / yearLeads and conducts compliance and ethics investigations across all business units and health plans, including but not limited to assessment of allegations, review of relevant documents, witness interviews, analysis of facts, root cause analysis, and preparation of investigation reports with recommended remedial or disciplinary actions. Education/Experience: A Bachelor's Degree in Related Field or Associates with 5 years of applicable experience, or a High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree, required.
SIU Investigator Centene Corporation GroupSIU InvestigatorKYRemote$56,200–$101,000 / yearEducation/Experience: Bachelor's degree, or an Associate's degree with an additional 2 years working on health care fraud, waste, and abuse investigations and audits in lieu of a Bachelors is required. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.