- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...This position will also review database information found in systems such as Unitrac, insurance company websites, Lexis Nexis,… more
- Travelers Insurance Company (Melville, NY)
- …position handles First Party Medical investigations that lead to resolution of claims . Provides quality claim handling throughout the investigation in ... partners. Manage provider bills and expense reserves by effectively utilizing all claim tools (dashboard, diary system , medical software, etc.). +… more
- Allied Universal (Charleston, WV)
- …for most full-time compliance and investigation jobs! Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss ... for Insurance claims through scene Investigations, claimant and witness Interviews, document...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Allied Universal (Pittsburgh, PA)
- …jobs! Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with ... policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- City of Norfolk, Virginia (Norfolk, VA)
- Paralegal Claims Investigator Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/4519534) Apply Paralegal Claims Investigator Salary ... City and related entities, and their employees. The Paralegal Claims Investigator 's role involves assistance in pre-litigation...after to a position with City of Norfolk Retirement System benefits, you will be required to contribute five… more
- The Hartford (Chicago, IL)
- …referred by the claim staff, or losses reviewed by the field investigator proactively which may be appropriate for SIU involvement. + The investigator ... SIU Investigator - CF08BE We're determined to make a...the state of Illinois, Wisconsin, Minnesota, and, at times, claims in Michigan, Indiana, and Iowa. The ideal candidate… more
- National General Insurance Company (TX)
- …customer communications, concerns, conflicts or issues + Summarizes documents and enters into claim system notes, documenting a claim file with notes, ... National General is seeking an SIU Field Investigator for the San Antonio, or Austin, TX...policy, coverage, and regulation + Applies broad knowledge of claim processes, policies, procedures, claim systems… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and ... to identify trends related to potentially inappropriate submission of claims by providers and collaborates with other team members...system enhancements, and prepay edits. The FWA Sr. Investigator Coder will be proficient at each step of… more
- Elevance Health (Middletown, NY)
- …entity review, interviewing, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims ... **Senior Investigator ( Investigator Sr)** _Location: This position...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- State of Colorado (Denver, CO)
- Labor Law: Compliance Investigator Intern Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4538708) Apply Labor Law: Compliance Investigator ... thorough as possible in documenting your education and work history in the application system . Attachments will not be accepted or considered during any phase of the… more
- Iowa Department of Administrative Services (Des Moines, IA)
- Investigator 2 Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4541853) Apply Investigator 2 Salary $50,252.80 - $76,336.00 Annually Location ... Iowa Workforce Development (IWD) is seeking a new team member for the role of Investigator 2 in the Unemployment Integrity Bureau. As an Investigator 2 the… more
- State of Massachusetts (MA)
- …Unemployment Assistance related to fraudulent activities by reviewing and investigating UI claim data and UI system transactions using pattern recognition ... data patterns and documents pertinent information concerning any potentially fraudulently claim activities or other alleged violations of laws, rules, and… more
- Elevance Health (St. Louis, MO)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... ** Investigator II** **Location** : This position will work...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- Elevance Health (West Des Moines, IA)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... ** Investigator II** **Schedule** : 1-2 days per week...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- EFI Global (Edina, MN)
- …manner; documents all relevant facts pertaining to files in the appropriate claims handling system (s) and keeps management informed of developments that ... requirements for consideration.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss,… more
- System One (Baltimore, MD)
- …Baltimore, MD (Hybrid) twice a week Job Duties: + Research provider/subscriber claims activity, operations manuals, data systems , medical policies, job duties ... ALTA IT is hiring an Associate Investigator to support a leading health insurance customer....if an individual has committed fraud for the investigators. System One, and its subsidiaries including Joule, ALTA IT… more
- Elevance Health (San Juan, PR)
- …Through its affiliated companies, they serve more than 118 million people. ** Investigator I** **Location:** This position will work a hybrid model (3-4 days/week ... hours or days may be required based on operational needs. The ** Investigator I** is responsible for investigating assigned cases, collecting, researching and… more
- State of Nevada (NV)
- COMPLIANCE/AUDIT INVESTIGATOR 3 APPROXIMATE ANNUAL SALARY - $58,025.52 to $86,150.88 PAY GRADE: 35 For more information on benefit and retirement programs, please ... provide work direction and training to others. The incumbent is a Compliance/Audit Investigator III in the Insurer/TPA Compliance Unit and serves as the lead worker… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …case files. + Experience with relevant technology, such as background check systems , claims processing platforms, data mining and fraud detection software. ... . As a member of Premera's Special Investigations Unit (SIU), the ** Investigator III** will be responsible for investigating allegations of external fraud, waste,… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Fraud Investigator - Anticipated Vacancy Augusta , Maine , United States | Investigative | Full-time Apply by: June 23, 2024 Apply with Linkedin Apply Department of ... falsification? The Maine Department of Labor seeks a Fraud Investigator to join our team. This position protects Maine's...documents submitted to the Bureau to determine if a claim is legitimate or Identity Theft. This can be… more