- 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...extract data for analysis from relevant data sources and systems . Knowledge of city, state and local regulations, legal… more
- Allied Universal (Cape Coral, FL)
- …explore a career with us and make a difference. Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....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...This position will also review database information found in systems such as Unitrac, insurance company websites, Lexis Nexis,… 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...financial impact for cases worked in the case management system . + Assist GIS and local management as appropriate… more
- State of Indiana (Indianapolis, IN)
- Claims Investigator Date Posted: Dec 12, 2025 Requisition ID: 469549 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with the ... Role Overview : The primary job responsibilities of a Claims Investigator are to investigate unemployment issues....hears and defend determinations. + Receive, investigate, and correct system error list related to wage reporting, claim… more
- NJ Transit (Newark, NJ)
- Investigator A ( Claims ) Finance Job Description: Move forward with us! At NJ TRANSIT, you'll join us in transforming the third-largest transportation agency in ... public agencies. + Carrying out negotiations in adjusting of claims and entering of settlements with attorneys. + Obtaining...maintaining a calendar of upcoming events; maintaining a diary system . + Maintaining both paper and electronic claim… more
- Allied Universal (Crossville, TN)
- …us and make a difference. Allied Universal(R) is hiring a SIU / Surveillance Investigator . SIU / Surveillance Specialists investigate claims with red flags that ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Kemper (Doral, FL)
- …to our stakeholders that delivers on our promises._ **Position Summary:** The SIU Investigator will conduct field as well as desk investigations of insurance ... claims referred to and accepted for investigation by the Special Investigative Unit. Our Special Investigator will function as a remote investigator working… more
- Allied Universal (Monroe, LA)
- …activities and capabilities to assist with the administration of an Insurance claim . + **Private Investigator 's license** **required** **prior to applying.** + ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic… 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems , claims flow, adjudication process, system edits and display ... Medical Investigator role. + Subject matter expert in health systems operations including an understanding of reimbursement methodologies and coding conventions… more
- EFI Global (St. Paul, MN)
- …manner; documents all relevant facts pertaining to files in the appropriate claims handling system (s) and keeps management informed of developments that ... buildings or residences.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, large… more
- MyFlorida (Pensacola, FL)
- LAW ENFORCEMENT INVESTIGATOR II - 41001250 1 Date: Dec 10, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 866581 Agency: Office of the Attorney General Working Title: LAW ENFORCEMENT INVESTIGATOR II - 41001250 1 Pay Plan: Career Service Position Number: 41001250… more
- UPMC (Pittsburgh, PA)
- …such as copiers, multi-line phone systems , fax machines and paging systems Preferred Qualification: + Experience in investigations, claims , medical coding, ... has an exciting opportunity for a Special Investigations Unit Investigator position. This is a temporary position working Monday...abuse (FWA) cases, as well as researching and analyzing claims data in order to identify potential FWA. The… more
- Centene Corporation (Frankfort, KY)
- …Word, Xcelys, SalesForce, and Microsoft Access. Knowledge and understanding of managed care claims processing systems and medical claims coding preferred ... teams as needed. + Supports the provider escalation project team to resolve claims and payment issues. + Identifies root-cause issues to ensure enterprise solutions… more
- St. Luke's University Health Network (Allentown, PA)
- …patient's ability to pay for health care. The Employee Relations Investigator reviews and investigates all assigned employee policy violations, complaints, concerns, ... disputes, claims of harassment, discrimination, and complaints of unfair treatment...with priority given to the most egregious allegations. The Investigator will have significant interaction with Human Resources, Operations… more
- Health Care Service Corporation (Tulsa, OK)
- …Certification, or acquire within 24 months of hire** **3 years experience in claims processing operations and reporting systems , including 2 years experience in ... auditing or developing computer system reports.** **Knowledge of accreditation, ie URAC, NCQA standards...URAC, NCQA standards and health insurance legislation.** **Awareness of claims processes and claims processing systems… 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
- CVS Health (Columbus, OH)
- …it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts ... fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business +...+ Documents all appropriate case activity in case tracking system + Facilitates feedback with providers related to clinical… more
- Elevance Health (Atlanta, GA)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims ... in order to recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible for identifying and developing… more
