- Premera Blue Cross (Mountlake Terrace, WA)
- …Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred . + (2) years of active experience in ... . As a member of Premera's Special Investigations Unit (SIU), the ** Investigator III** will be responsible for investigating allegations of external fraud, waste,… more
- EFI Global (Edina, MN)
- …Certified Fire & Explosion Investigator (CFEI) certification. IAAI Certified Fire Investigator (IAAI-CFI) is preferred and will be required within 6 months ... requirements for consideration.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss,… more
- EFI Global (Philadelphia, PA)
- …Certified Fire & Explosion Investigator (CFEI). IAAI Certified Fire Investigator (IAAI-CFI) certification is preferred . Will be required to obtain ... and RESPONSIBILITIES** **Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of… more
- EFI Global (Chantilly, VA)
- …minimum certification requirement of CFEI to be considered. IAAI Certified Fire Investigator (IAAI-CFI) certification preferred or required within 6 months of ... meet certification requirements.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss,… more
- Allied Universal (Crossville, TN)
- …investigation jobs! Allied Universal(R) is hiring a Special Investigations Unit / Claims Investigator . Special Investigations Unit (SIU) Specialists investigate ... 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
- 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 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...Property and Casualty insurance experience of 1-3 years highly preferred ; + Preference given to those with Claim… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …collegially with colleagues. Additional qualifications as specified by the Principal Investigator . PREFERRED QUALIFICATIONS: PhD or equivalent research degree in ... research, which encompasses the analysis of national cancer registries, medical claims databases, and electronic health record (EHR) data. They will collaborate… more
- JBS USA (Greeley, CO)
- **Deductions/ Claims Investigator ** **Purpose and Scope/General Summary:** We are looking for a Deductions/ Claims Investigator for our Fed Beef division. ... This role will sit at our Corporate office in Greeley, CO. The Deductions/ Claims Investigator responds to notifications of discrepancies that may be reported by… more
- Command Investigations (Orlando, FL)
- …for hire. Visit our website and find out why at www.GoCommand.com. The Claims /Field Investigator should demonstrate proficiency in the following areas: + Writing ... are a few characteristics of our Investigators and staff. Bilingual candidates are preferred ! If you have the desire to operate at your highest professional level… more
- The Hartford (NJ)
- …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...General Liability lines-of-business. SIU Investigators work in partnership with claim handlers across all lines of business to investigate… more
- National General Insurance Company (Uniondale, NY)
- …Manhattan, Brooklyn, The Bronx, Queens and Staten Island NY. Previous SIU claims and/or law enforcement investigation experience preferred ** Job Summary: This ... ** This role is a field Investigator role where the investigator would...responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation… more
- Elevance Health (Iselin, NJ)
- …on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, interviewing, law enforcement ... for payment as part of consideration for employment. **Senior Investigator ** + Job Family: FRD > Investigation + Type:...referral, and use of proprietary data and claim systems for review of facility, professional and… more
- Elevance Health (Columbus, OH)
- …and claim systems for review of facility and professional claims . + Responsible for independently identifying and developing enterprise-wide specific healthcare ... check, or ask you for payment as part of consideration for employment. **Senior Investigator ** + Job Family: FRD > Investigation + Type: Full time + Date Posted:Apr… more
- Elevance Health (Columbus, OH)
- …paid on fraudulent claims . **How will you make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... required with understanding of health insurance policies, health insurance claims handling and provider network contracting. ** Preferred Qualifications**… more
- Elevance Health (Columbus, OH)
- …you a check, or ask you for payment as part of consideration for employment. ** Investigator I** + Job Family: FRD > Investigation + Type: Full time + Date Posted:Apr ... ATLANTA + OH, COLUMBUS + OH, COLUMBUS + TN, NASHVILLE **Description** **JR111671 Investigator l** **Location** : This position will work a hybrid model (remote and… more
- Allied Universal (Coventry, RI)
- …Compliance and Investigations, North America's leading expert insurance claim investigations, compliance and corporate governance company, provides rewarding ... and investigation jobs! Allied Universal(R) is hiring a Surveillance Investigator . Surveillance Investigators perform discreet mobile and stationary surveillance of… more
- State of Massachusetts (MA)
- …Assistance related to fraudulent activities by reviewing and investigating UI claim data and UI system transactions using pattern recognition database and ... data patterns and documents pertinent information concerning any potentially fraudulently claim activities or other alleged violations of laws, rules, and… more
- State of Massachusetts (Boston, MA)
- …agencies, municipalities, law enforcement and public prosecutors. AOI may be investigating claims of public corruption or other wrongdoing in a number of public ... of public funds, even when no crime or civil action is involved. *Senior Investigator : Position Overview* The Senior Investigator reports to the Director and… more
- State of Georgia (Fulton County, GA)
- …the State of Georgia Demonstrated experience in the analysis of Medicaid/Medicare claims . Preferred Qualifications: In addition to meeting the minimum ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only) Hot… more