OTHER

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Overview:
Company Overview: Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you’re ready to grow with the best, explore a career with us and make a difference.

Job Description:
Allied Universal® is hiring a Surveillance Investigator. 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. <ul style="margin: 0px; padding: 0px; font-family: verdana;"><li style="margin: 0px 0px 0px 22px; padding: 0px; font-size: 10pt; font-family: Verdana, Verdana_MSFontService, sans-serif;" aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1440,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="37" data-aria-level="1">Pay Rate: $20 - $22 / hr<span style="margin: 0px; padding: 0px; font-size: 10pt; font-family: Verdana, Verdana_EmbeddedFont, Verdana_MSFontService, sans-serif; color: #2d2d2d;" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335559685":700,"335559737":-20,"335559738":0,"335559739":0,"335559740":279}"> </li></ul><ul style="margin: 0px; padding: 0px; font-family: verdana;"><li style="margin: 0px 0px 0px 22px; padding: 0px; font-size: 10pt; font-family: Verdana, Verdana_MSFontService, sans-serif;" aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1440,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="38" data-aria-level="1">Private Investigator’s license required prior to applying<span style="margin: 0px; padding: 0px; font-size: 10pt; font-family: Verdana, Verdana_EmbeddedFont, Verdana_MSFontService, sans-serif; color: #2d2d2d;" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335559685":700,"335559737":-20,"335559738":0,"335559739":0,"335559740":279}"> </li></ul><ul style="margin: 0px; padding: 0px; font-family: verdana;"><li style="margin: 0px 0px 0px 22px; padding: 0px; font-size: 10pt; font-family: Verdana, Verdana_MSFontService, sans-serif;" aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1440,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="39" data-aria-level="1">Must possess a valid driver's license with at least one year of driving experience<span style="margin: 0px; padding: 0px; font-size: 10pt; font-family: Verdana, Verdana_EmbeddedFont, Verdana_MSFontService, sans-serif; color: #333333;" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335559685":700,"335559737":-20,"335559738":0,"335559739":0,"335559740":279}"> </li></ul> RESPONSIBILITIES:<ul><li>Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability</li><li>Utilize various surveillance techniques and equipment to monitor subjects covertly</li><li>Document and report observations, activities, and any relevant information in a clear and concise manner</li><li>Collaborate with other investigators and law enforcement agencies as needed to gather information and coordinate efforts</li><li>Maintain confidentiality and adhere to legal and ethical standards in conducting surveillance operations</li></ul>QUALIFICATIONS (MUST HAVE):<ul><li>High school diploma or equivalent</li><li>Post offer, must be able to successfully complete the Allied Universal Investigations' training/orientation course</li><li>Minimum of one (1) year of verifiable work experience, preferably involving investigations or other protective service-related field</li><li>Flexibility to work varied and irregular hours/days including weekends and holidays</li><li>Ability to type reports in Microsoft Word format with minimal grammatical and punctuation errors</li><li>Proficient in utilizing laptop computers, video cameras and cell phones</li><li>Capable of maintaining focus and multitasking effectively in a dynamic environment</li><li>Demonstrated ability to manage stressful situations with composure and professionalism</li><li>Ability to work in a very independent environment</li></ul>PREFERRED QUALIFICATIONS (NICE TO HAVE):<ul><li>Associate’s Degree or higher, preferably in Criminal Justice</li><li>Security/Loss Prevention experience</li><li>Military experience</li><li>Law enforcement experience</li><li>Prior insurance investigations experience</li><li>Prior educational or professional incident reporting and/or investigations experience</li></ul>BENEFITS:<ul><li>Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance</li><li>Seven paid holidays annually, sick days available where required by law</li><li>Vacation time offered at an initial accrual rate of 3.08 hours biweekly; unused vacation is only paid out where required by law</li></ul>

Closing:
Allied Universal® is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.

Requisition ID:
2026-1593517

Allied Universal provides unparalleled service, systems and solutions to the people and business of our communities, and is North America's leading security services provider. With over 140,000 employees, Allied Universal delivers high-quality, tailored solutions, which allows clients to focus on their core business. For more information: 866.825.5433 or <a href="http://www.aus.com/" target="_blank">www.AUS.com</a>

Allied Universal

Surveillance Investigator

Accidental Death and Dismemberment (AD&D)

Cellular Telephone

Computer Skills

Criminal Justice

Data Collection

Disability Insurance

Driver's License

High School Diploma

Insurance

Insurance Claims

Laptop PC

Law Enforcement

Legal

Legal Standards

Loss Prevention

Microsoft Word

Military

Multitasking

Protective Services

Surveillance

[AW]-iCims

ADAPTED_NOW

Certified Fraud Examiner (CFE), Certifications through America’s Health Insurance Plans (AHIP), Healthcare Anti-Fraud Association (HCAFA) and/or Managed Healthcare Professional (MHP), Accredited Health Care Fraud Investigator (AHFI), and/or Certified Professional Coder (CPC) are preferred . $83,000.00 - $132,800.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level.

YEAR

Job Summary:The Manager, Program Integrity is responsible for managing Program Integrity requirements to include allegation intake, report analysis, triage, investigation, correction and reporting of fraud, waste and abuseEssential Functions:<ul><li>Responsible for deposition, testifying in court in support of CareSource and Attorney General legal actions</li><li>Manage all efforts of your investigative team focusing on thorough but timely investigations, highest impact prioritization, root cause identification, state and federal law enforcement collaboration, evidence development and investigative actions</li><li>Drive and encourage innovative approaches to increase department effectiveness and efficiency</li><li>Ensure quantitative and qualitative measures are used to meet performance objectives</li><li>Develops and maintains key business contacts for investigative and SIU management purposes</li><li>Ensure employees meet all state and federal contract requirements and follow department work processes</li><li>Lead the Investigative team through investigative resolution including corrective action plans, terminations, Fair Hearings, recoveries, negotiations, mediation, and litigation</li><li>Mentor employees on effective and through investigative case presentation</li><li>Mentor direct reports including, coaching, development, performance feedback, disciplinary issues, annual performance evaluations and bonus review</li><li>Lead and promote Employee Engagement</li><li>Drive fraud identification through information sharing efforts, OIG Work Plan, Fraud Task Force participation and seminars</li><li>Drive internal process and procedure changes by working with cross departmental teams to resolve identified internal system gaps that may present a FWA or financial risk to CareSource</li><li>Take a leadership role in state and federal regulatory audits</li><li>Proactively manage investigative team growth to meet new business requirements</li><li>Take a leadership role in state and federal program integrity operations and fraud organizations such as NHCAA, HFPP, and ACFE</li><li>Speak at national conferences on investigative efforts and fraud trends.</li><li>Develop and maintain an in-depth knowledge of the company’s business and regulatory environments</li><li>Works closely with leadership to establish, communicate, and perpetuate the corporate vision, ensuring appropriate communication to all stakeholders</li><li>Recognize and proactively manage operational dependencies and risks</li><li>Maintains a framework of standards and best practice methodologies that are repeatable and evidence based</li><li>Participate in strategic planning and implement action plans</li><li>Perform any other jobs, as requested</li></ul>Education and Experience:<ul><li>Bachelor of Science/Arts Degree in Criminal Justice, Medical/Health Care Field or related industry or equivalent years of relevant work experience is required</li><li>Minimum of six to eight (6-8) years of investigative or health care experience is required</li><li>Extensive experience in health care, legal, auditing, claims and/or investigative services is required</li><li>Leadership/supervisory experience preferred</li></ul>Competencies, Knowledge and Skills:<ul><li>Demonstrated leadership qualities</li><li>Support the development of effective working relationships with business partners</li><li>Solid understanding of claims processing preferred</li><li>Knows and uphold the provisions of the Corporate Compliance Plan</li><li>Intermediate to advanced proficiency level of computer skills, including Microsoft Outlook, Word, Excel, Access, and Power Point</li><li>Advanced troubleshooting and problem-solving capabilities</li><li>Effective communication and interaction skills</li><li>Ability to formally present to a wide audience internally and at national conferences</li><li>Ability to lead a team and achieve performance metrics</li><li>Highest levels of ethics, integrity and professionalism</li><li>Significant knowledge of government program compliance requirements – Medicare, Medicaid, Affordable Care Act (ACA), etc. preferred</li><li>Significant knowledge of medical insurance and/or state regulatory requirements</li></ul>Licensure and Certification:<ul><li>Certified Fraud Examiner (CFE), Certifications through America’s Health Insurance Plans (AHIP), Healthcare Anti-Fraud Association (HCAFA) and/or Managed Healthcare Professional (MHP), Accredited Health Care Fraud Investigator (AHFI), and/or Certified Professional Coder (CPC) are preferred </li></ul>Working Conditions:<ul><li>General office environment; may be required to sit or stand for extended periods of time</li></ul>Compensation Range: $83,000.00 - $132,800.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.Compensation Type: SalaryCompetencies: - Fostering a Collaborative Workplace Culture- Cultivate Partnerships- Develop Self and Others- Drive Execution- Influence Others- Pursue Personal Excellence- Understand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-SD1

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Surveillance Investigator Allied Universal

Manager SIU CareSource

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