Fraud Claims Investigator Jobs

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43 Fraud Claims Investigator jobs found on Monster.

Jobs 1 to 20 of 43
Department Overview Cahaba Safeguard Administrators LLC Benefit Integrity Investigations (BI) leads efforts to identify, investigate and reduce fraud and abuse to the Medicare Program. By working with Medical Review and Data Analysis partners, BI identifies potential aberrancies that require further review to determine if an actual loss to the Program has occurred. Once a loss has been identified,...
Department Overview Cahaba Safeguard Administrators LLC Benefit Integrity Investigations (BI) leads efforts to identify, investigate and reduce fraud and abuse to the Medicare Program. By working with Medical Review and Data Analysis partners, BI identifies potential aberrancies that require further review to determine if an actual loss to the Program has occurred. Once a loss has been identified,...
Department Overview Cahaba Safeguard Administrators LLC Benefit Integrity Investigations (BI) leads efforts to identify, investigate and reduce fraud and abuse to the Medicare Program. By working with Medical Review and Data Analysis partners, BI identifies potential aberrancies that require further review to determine if an actual loss to the Program has occurred. Once a loss has been identified,...
MetLife, a leading provider of insurance and other financial services to individual and institutional customers, is seeking a Claims Investigator in Oriskany, NY, Tampa, FL, Aurora, IL and Atlanta, GA! Beyond meaningful and challenging work, MetLife provides a variety of flexible work arrangements, as well as a tuition reimbursement program, competitive benefits, and retirement and pension plans....
PRIVATE INVESTIGATOR - needed for growing company. Position requires daily surveillance of suspected fraudulent insurance claims in our service area. We are currently in need of investigators in the Boston, MA area. We are currently looking for people who have 1-2 years of experience for full time surveillance positions. All investigators must check in with office manager throughout the day to pro...
Description Job duties include but are not limited to the following: - Identifies, investigates and evaluates moderate to complex potential fraud, waste or abuse, including pre-pay and/or post-pay medical claim reviews to determine valid cases for appropriate action; documents findings, and prepares case referrals, letters, etc. if applicable. - Ensures investigative data requests are compliant, d...
Full-time, in-house position is responsible for identifying and analyzing Worker’s Compensation claims data to identify, categorize and report all areas of suspected fraud. This position requires a well-developed understanding of the insurance claims industry. General Responsibilities: Conducts claim analysis to identify persons or organizations committing insurance fraud. Conduct investigations a...
GlobalOptions, an international investigative firm servicing the insurance, government, and legal communities is currently seeking an experienced SIU investigator to join our team. We perform surveillance, activity checks, and background investigations on worker's compensation, auto liability, general liability, and long and short term disability claims. Assignments will be throughout the Philadel...
Position Description As an Insurance SIU Desk Investigator, your responsibilities will include: o Investigating suspicious insurance claims or suspicious insurance related activities covering all lines of business involving claimants, agents, brokers, attorneys, medical providers, etc., to support the Claims Organization for the pursuit of appropriate remedies through the civil or criminal justice...
If you are a keen observer with an eye for detail and always gives 110% in order to achieve success, then a career as a private investigator is custom-made for you! Claims Verification Inc. (CVI) is looking for qualified candidates for a LICENSED INSURANCE FRAUD INVESTIGATOR TRAINEE position in the Portland, ME area. Qualified candidates must live in the area and cover the adjoining areas of the s...
Position Description: Universal American is a New York Stock Exchange company with annual revenues of more than $2 billion. Through our family of healthcare companies, we provide health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals in order to improve the health and well-being of those we serve and reduce healthcar...
Position Description As an Insurance SIU Desk Investigator, your responsibilities will include: o Investigating suspicious insurance claims or suspicious insurance related activities covering all lines of business involving claimants, agents, brokers, attorneys, medical providers, etc., to support the Claims Organization for the pursuit of appropriate remedies through the civil or criminal justice...
Position Description As an Insurance Principle Investigator your responsibilities will include: - Gather facts on issues in question through open-ended interviewing and statement taking of witnesses, employers, claimants and other relevant witnesses. - Obtaining and presenting physical and documentary evidence to support investigations. - Preparing objective and concise written reports of investig...
Position Description As an Insurance SIU Desk Investigator, your responsibilities will include: o Investigating suspicious insurance claims or suspicious insurance related activities covering all lines of business involving claimants, agents, brokers, attorneys, medical providers, etc., to support the Claims Organization for the pursuit of appropriate remedies through the civil or criminal justice...
If you are a keen observer with an eye for detail and always gives 110% in order to achieve success, then a career as a private investigator is custom-made for you! Claims Verification Inc. (CVI) is looking for qualified candidates for INSURANCE FRAUD INVESTIGATOR TRAINEE position in the Bronx/Brooklyn, NY area. Qualified candidates must live in the area and cover the adjoining areas of the state...
We are seeking a motivated, licensed private investigator to conduct surveillance on insurance fraud cases in the Boston, MA and surrounding areas. WE PROVIDE THE VEHICLE AND EQUIPMENT! WE CAN PROVIDE FULL-TIME WORK, WITH AT LEAST 40 HOURS A WEEK! Are you tired of trying to compete your skills against the "big" nationwide investigative companies? Are you tired of the wear and tear investigations d...
If you are a keen observer with an eye for detail and always gives 110% in order to achieve success, then a career as a private investigator is custom-made for you! Claims Verification Inc. (CVI) is looking for qualified candidates for INSURANCE FRAUD INVESTIGATOR TRAINEE positions in the Pottsville, PA area. Qualified candidates must live in the area and cover the adjoining areas of the state as...
Position Description: Universal American is a New York Stock Exchange company with annual revenues of more than $2 billion. Through our family of healthcare companies, we provide health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals in order to improve the health and well-being of those we serve and reduce healthcar...
If you are a keen observer with an eye for detail and always gives 110% in order to achieve success, then a career as a private investigator is custom-made for you! Claims Verification Inc. (CVI) is looking for qualified candidates for INSURANCE FRAUD INVESTIGATOR TRAINEE position in the Plattsburgh, NY area. Qualified candidates must live in the area and cover the adjoining areas of the state as...
The Investigator performs complex data mining, data analysis and general investigation into allegations of fraud, waste and abuse in order to recover and safeguard Harvard Pilgrim Health Care financial assets. ESSENTIAL FUNCTIONS: Initiates and conducts data mining and data analysis using HPHC fraud, waste and abuse (FWA) detection software and HPHC claims data to develop evidence supporting alleg...

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Answers for Fraud Claims Investigator Jobs

Questions & Answers Powered by Yahoo! Answers
9/11 inside job or not?
Whatdo you think
Is US Claims Services in CA a fraud?
They want me to send them $20 with the possibility to recover unclaimed money from a previous job. anyone ever heard of this? what's the deal?

Business Career Tools

Claims Investigator - Fraud

Salaries

$27,040.00 - $89,670.00
Typical Salary for Claims Investigator - Fraud
(88 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
56.9%
Some College Coursework Completed
13.8%
Master's
13.8%
Associates
8.6%
High School
6.9%
(58 Respondents)
Source: Monster.com Careerbenchmarking Tool

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