- Usaa (Parkersburg, WV)
- …us special and impactful. The Opportunity We are looking for a SIU Investigator (mid-level). This is a desk position. Within defined guidelines and framework, ... protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance… more
- SGI Global, LLC (Minneapolis, MN)
- …| Full Time SGI Global is seeking an Affirmative Civil Enforcement (ACE) Investigator /Analyst to support the United States Attorney's Office, District of ... Minnesota to support the Assistant United States Attorneys (AUSAs) within the...ACE efforts, including participating in witness interviews. + Analyzing claims data using Excel and other tools to identify… more
- AIG (Atlanta, GA)
- …and reporting on findings. The investigator will provide assistance to the claims adjuster in progressing the claim and will leverage knowledge and expertise ... customers to manage risk. Join us as a Principal Claims Investigator to play your part in...business involving claimants, brokers, lawyers, medical providers, etc., to support the Claims organization. + Obtain and… more
- Commonwealth of Pennsylvania (PA)
- …the Office of Administration);or + Seven years of experience as an insurance investigator , underwriter, agent, broker or claims adjuster. College level training ... of determining your eligibility for the position. Information to support your eligibility for the position must be provided...How many years of full-time experience as an insurance investigator , underwriter, agent, broker or claims adjuster… more
- Commonwealth of Pennsylvania (PA)
- Professional Conduct Investigator Supervisor - Philadelphia Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5169507) Apply Professional ... Conduct Investigator Supervisor - Philadelphia Salary $67,736.00 - $102,905.00 Annually...of determining your eligibility for the position. Information to support your eligibility for the position must be provided… more
- Commonwealth of Pennsylvania (PA)
- Professional Conduct Investigator 1 Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5167762) Apply Professional Conduct Investigator 1 ... fieldwork in Philadelphia County. DESCRIPTION OF WORK As a Professional Conduct Investigator 1, you will be responsible for planning, coordinating, and conducting… more
- USAA (San Antonio, TX)
- …us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). **This is a "Desk" position.** **Besides solid experience as an SIU ... Investigator within P&C, you will have strong underwriting skillset...framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity… more
- Commonwealth of Pennsylvania (PA)
- Bilingual Labor Law Investigator (Labor Law Investigator ) Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5171179) Apply Bilingual Labor ... Law Investigator (Labor Law Investigator ) Salary $51,971.00 - $79,062.00 Annually Location *Home Headquartered, PA Job Type Non-Civil Service Permanent Full-time… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... All Levels + Must meet the NYS DFS's and the NYS OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... justice or a related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation experience with law… more
- UPMC (Pittsburgh, PA)
- …UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator position. This is a temporary position working Monday through Friday 8:00 ... direction of the manager, the Special Investigations Unit (SIU) Investigator is responsible for investigating assigned fraud, waste and...abuse (FWA) cases, as well as researching and analyzing claims data in order to identify potential FWA. The… more
- The County of Los Angeles (Los Angeles, CA)
- INTERNAL AFFAIRS INVESTIGATOR , PROBATION Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/5093569) Apply INTERNAL AFFAIRS INVESTIGATOR , ... the level ofAssistant Probation Director (https://www.governmentjobs.com/careers/lacounty/classspecs/1066129?keywords=assistant%20probation%20&pagetype=classSpecifications) or as an Investigator , Detective, or Agent with a state, county, or… more
- Humana (Oklahoma City, OK)
- …first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of Investigators conducts ... of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As...line of business. As the Senior Fraud and Waste Investigator , you will serve as Humana's Program Integrity Officer,… more
- AmeriHealth Caritas (Columbia, SC)
- …services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported, ... Proactively performs research using the Internet, data analysis tools, etc., to analyze aberrant; claims billing and practice patterns. + Analyzes data as part of the… more
- Humana (Santa Fe, NM)
- …help us put health first** Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit. Do you enjoy ... an in-depth evaluation of variable factors. The Fraud and Waste Investigator collaborates in investigations with law enforcement authorities. Assembles evidence and… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Legal Investigator Recruitment # 250804-3241AR-001 Location Hartford, CT Date Opened 12/12/2025 10:00:00 AM Salary *$86,068 - $110,931/year (Employees new to state ... the Attorney General (https://portal.ct.gov/ag) is recruiting for a Legal Investigator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=3241AR&R1=&R3=) located in Hartford, CT. What We Can… more
- Idaho Division of Human Resources (ID)
- Pesticide Investigator , Senior - Lewiston and Post Falls Posting Begin Date: 2025/09/09 Category: Agriculture Sub Category: Natural Resources Work Type: Full Time ... The Idaho Department of Agriculture is currently recruiting for a Pesticide Investigator , Senior in the division of Agriculture Resources located in Lewiston and… more
- Point32Health (Canton, MA)
- …about who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Investigator I is an essential team member of the Special Investigation Unit ... ("FWA") investigations under the direction of the Manager, FWA Prepayment Review. The Investigator I works closely with other members of the SIU to set investigative… more
- Health Care Service Corporation (Tulsa, OK)
- …medical, contractual, legislative, policy, and other information to validate claims submitted and billed. Conducting research; preparing documentation of findings ... or acquire within 24 months of hire** **3 years experience in claims processing operations and reporting systems, including 2 years experience in auditing… more
- Elevance Health (Atlanta, GA)
- …week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office ... recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible...company health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review,… more
