Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)NY$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.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)NY$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.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)NJ$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.
SIU Investigator - NY Labor Law Allied UniversalSIU Investigator - NY Labor LawEdison, New Jersey$32–$40 / hourAcquire 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 .
EEO Investigator Integrated Resources, IncEEO InvestigatorNew York, NY$60–$65 / hourStrong people skills with the ability to effectively navigate within a large organizational structure. Ability to work in a fast-paced healthcare/hospital setting.
CPC Investigator Horizon Healthcare ServicesCPC InvestigatorNewark, New JerseyThe Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. $70,500 - $94,395 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
CPC Investigator Blue Cross and Blue Shield AssociationCPC InvestigatorNewark, NJ$70,500–$94,395 / yearThe Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. The incumbent will also be responsible for handling low level investigative activities (external) related to claims, enrollment, accounting, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct.
Asset Protection Investigator (GME + eBay) Collectors Holdings, Inc.Asset Protection Investigator (GME + eBay)Jersey City, NJ$61,396–$99,678 / yearWork with the Head of Global Asset Protection to proactively identify gaps/areas of improvement with respect to digital security systems (access control, video surveillance, video storage) or physical processes that create exposure to theft. Excellent analytical skills and broad experience documenting investigations with the ability to think outside the box, handle multiple projects simultaneously, and build relationships with internal and external stakeholders.
AML Investigator I Valley National BancorpAML Investigator IMorristown, NJManage complex cases involving matters such as multiple relationship accounts, international wires involving Bank-designated high risk jurisdictions, and complex cash structuring schemes. Responsibilities include but are not limited to: Review and analyze alerts generated by the Bank's electronic monitoring software to make a determination as to whether activity warrants further review.
Assistant Chief Investigator Manhattan District Attorney's OfficeAssistant Chief InvestigatorNY$165,000–$185,000 / yearIn addition to the Minimum Qualification Requirements, candidates must possess the following: A baccalaureate degree from an accredited college and four years of full-time experience in the performance of criminal investigations, 18 months of which must have been in an administrative, managerial, executive, or supervisory capacity; Education and/or experience equivalent to "1" above. Must possess a valid certificate of completion from a New York State Basic Course for Police Officers academy or must be eligible to attend and successfully complete a Police Officer refresher course.
EEO Investigator Atria ConsultingEEO InvestigatorNew York, NY$55–$60 / hourWhen determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). Candidates must be comfortable working in a fast-paced healthcare environment and traveling to various facilities throughout New York City as needed.
SIU Investigator Centene Corporation GroupSIU InvestigatorNY$56,200–$101,000 / year5+ years in healthcare field working in fraud, waste and abuse investigations and audits, (or) 5+ years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, (or) 7+ years of professional investigation experience involving economic or insurance related matters. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.
Principal Financial Investigator Manhattan District Attorney's OfficePrincipal Financial InvestigatorNY$100,786–$114,387 / yearThe Office's Professional Staff perform a variety of key functions, including supporting the Trial Division, Investigation Division, Special Victims Division, Pathways to Public Safety Division, and Appeals Division, which handles all the Office's matters in state and federal appellate courts. Minimum Qualification Requirements: A baccalaureate degree from an accredited college or university, with a major in accounting and eight (8) years of satisfactory diversified accounting and auditing experience, at least two (2) years of which must have been in the supervision of staff engaged in fiscal or accounting investigations; or.
Forensic Accountant Investigator Manhattan District Attorney's OfficeForensic Accountant InvestigatorNY$108,601–$122,456 / yearThe Office's Professional Staff perform a variety of key functions, including supporting the Trial Division, Investigation Division, Special Victims Division, Pathways to Public Safety Division, and Appeals Division, which handles all the Office's matters in state and federal appellate courts. Minimum Qualification Requirements: A baccalaureate degree from an accredited college or university, with a major in accounting and eight (8) years of satisfactory diversified accounting and auditing experience, at least two (2) years of which must have been in the supervision of staff engaged in fiscal or accounting investigations; or.
Financial Investigator Manhattan District Attorney's OfficeFinancial InvestigatorNY$64,172–$69,548 / yearThe Office's Professional Staff perform a variety of key functions, including supporting the Trial Division, Investigation Division, Special Victims Division, Pathways to Public Safety Division, and Appeals Division, which handles all the Office's matters in state and federal appellate courts. Minimum Qualification Requirements: High school graduation or equivalent and three years of experience in community work or community centered activities in an area related to duties described above; or.
Surveillance Investigator VRC InvestigationsSurveillance InvestigatorNewark, New JerseyVRC 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.
Investigator Ethos Risk ServicesInvestigatorJersey City, NJPart 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.
Investigator - Network Services - Full Time CoventBridge GroupInvestigator - Network Services - Full TimeStaten Island, New York$26–$30 / hourFull timeCoventBridge 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.
Entry-Level Investigator Ethos Risk ServicesEntry-Level InvestigatorJersey City, NJFull timeOur 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 file by submitting case reports and uploading video footage via personal laptop at the end of the day.
Special Investigations Unit Clinical Certified Coder Metroplus Health Plan IncSpecial Investigations Unit Clinical Certified CoderNY$100,000–$110,000 / yearMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics.
Special Investigation Unit (SIU) Manager CVS Health CorpSpecial Investigation Unit (SIU) ManagerNJ$54,300–$159,120 / yearThe Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record reviews for medical, behavioral, transportation, and other healthcare providers. Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates findings effectively to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, and state regulators.
Special Agent U.S. Department of Homeland SecuritySpecial AgentNY$48,854–$118,204 / yearOR Have at least 1 year of specialized experience equivalent to the GL-9 level (such as experience in or related to planning and conducting complex criminal investigations to determine violations of Federal laws and regulations; collecting and assembling facts to identify logical conclusions; gathering, analyzing, and evaluating evidence or data; conducting interviews and interrogations; making arrests; conducting searches and seizures; taking responsibility for own actions and those of team members to ensure the goals and deadlines for the team are met; partnering with or leveraging networks or relationships from outside the organization; experience managing complex projects including setting priorities and determining resource requirements). OR Have at least 1 year of specialized experience equivalent to the GL-7 level (such as experience applying law enforcement, protective, or investigative techniques in the performance of job duties; identifying problem areas and proposing and implementing solutions; taking responsibility for own actions and those of team members to ensure the goals and deadlines for the team are met; leading meetings or seminars on behalf of a professional or academic group; setting work priorities and allocating resources; partnering with other individuals from within and outside the organization).
Part-Time Written Exam Proctor - Goshen - Vacancy ID# 218970 New York State Thruway AuthorityPart-Time Written Exam Proctor - Goshen - Vacancy ID# 218970Goshen, NYDuties: Understands and complies with all examination guidelines; Checks in examinees, verifies identification and explains exam process; Reads routine instructions to examinees; Monitors examinees during test sessions to ensure a secure testing environment; Assists in the distribution and collection of exam materials to examinees; Assists in the preparation of test materials for return to the Licensing Examination Unit in Albany; Provides aid to examinees in the completion of exam papers before testing begins; Reports suspected irregularities to the Written Exam Supervisor; Controls admission to and from the exam room; Fills out appropriate paperwork for the various exams that are administered; Assists in the training of new hires; Arrives on time; Performs other duties as assigned. Individuals must have the legal right to work in the United States; possess strong customer service skills; be able to work with people under stressful conditions in a calm and courteous manner; be able to stand and walk for 75% of the time; be able to lift and move up to 20 lbs; have the ability to work a flexible schedule.
Part-Time Written Exam Proctor - Goshen - Vacancy ID# 216577 New York State Thruway AuthorityPart-Time Written Exam Proctor - Goshen - Vacancy ID# 216577Goshen, NYDuties: Understands and complies with all examination guidelines; Checks in examinees, verifies identification and explains exam process; Reads routine instructions to examinees; Monitors examinees during test sessions to ensure a secure testing environment; Assists in the distribution and collection of exam materials to examinees; Assists in the preparation of test materials for return to the Licensing Examination Unit in Albany; Provides aid to examinees in the completion of exam papers before testing begins; Reports suspected irregularities to the Written Exam Supervisor; Controls admission to and from the exam room; Fills out appropriate paperwork for the various exams that are administered; Assists in the training of new hires; Arrives on time; Performs other duties as assigned. Individuals must have the legal right to work in the United States; possess strong customer service skills; be able to work with people under stressful conditions in a calm and courteous manner; be able to stand and walk for 75% of the time; be able to lift and move up to 20 lbs; have the ability to work a flexible schedule.