Medical Reviewer III - Managed Care Project (MCP) - REMOTE
The Medical Reviewer III (MCP) will be responsible for conducting clinical reviews of medical records for the Medicaid Managed Care Project (MCP). Applies Medicaid guidelines in making clinical determinations as to the appropriateness of payment coverage.
In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse.
This position will report directly to the Medical Review Supervisor and will work in our Grove City, OH office. If not local, remotely from a home office.
Responsibilities/ Requirements
Responsibilities:
Using knowledge of Medicaid state and federal laws, rules, and regulations, to contribute to the development of review criteria to be approved for use in the review of claims
Review information contained in project plan to ensure claims are paid correctly, documentation supported services as provided, etc.
Utilize extensive knowledge of medical terminology, ICD-10-CM, HCPCS Level II and CPT coding along with analysis and processing of Medicaid claims; Utilize MCP guidelines for coverage determinations, and utilize state specific guidelines and regulations for claim determinations
Coordinate and compile written Investigative Summary Reports in conjunction with PI Investigators upon completion of the records review
Uses leadership and communication skills to collaborate with physicians and other health professionals, as well as external regulatory agencies and law enforcement personnel
Provide expert witness testimony as required
Complete assignments in a manner that meets or exceeds the quality assurance goal of 95% accuracy
Maintains chain of custody on all documents and follows all confidentiality and security guidelines
Perform other duties as assigned by the Medical Review Supervisor that contribute to UPIC goals and objectives, comply with the Program Integrity Manual (PIM), Statement of Work (SOW) guidelines, and CMS directives and regulations
Requirements:
Knowledge of, and the ability to correctly identify Medicaid coverage guidelines
Ability to read a Medicaid claim and basic knowledge of Medicaid claims
Excellent verbal and written communication skills
Knowledge of and ability to use Microsoft Word, Excel, and Internet applications
Ability to efficiently organize and manage workload and assignments
Educational/Experience Qualifications:
Graduated from an accredited school of nursing and has an active license as a Registered Nurse (RN)
At least 4 years' utilization/quality assurance review and ICD-10-CM/CPT-4 coding experience
At least 4 years' experience in coding and abstracting; working knowledge of Diagnosis Related Groups (DRGs) is required
Advanced knowledge of medical terminology and experience in the analysis and processing of Medicaid claims, utilization review/quality assurance procedures, ICD-10-CM and CPT-4 coding, Medicaid coverage guidelines, and payment methodologies (i.e., Correct Coding Initiative, DRGs), NCPDP and other types of prescription drug claims is required
Benefits
Medical, Dental, Vision plans
Life, LTD and STD paid by the employer
401(k) with company match up to 4%
Paid Time Off and company paid holidays
Tuition assistance after 1 year of service
The salary range for this role is $65,000 to $75,000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
About Us:
CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
$65k-75k yearly Auto-Apply 22d ago
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Surveillance Investigator
Coventbridge Group 3.8
Coventbridge Group job in Sarasota, FL
Now Building Our Florida Bench: Private Field Surveillance Investigator (Current and Future Openings)
Location: Tampa / Sarasota, FL (field-based) | Type: Independent/Field Investigations (Surveillance) | Schedule: Flexible
CoventBridge Group is growing-and we're hiring now while also building our pipeline for upcoming surveillance needs across Florida. This is a great opportunity for experienced investigators who are ready to take cases today, as well as professionals who want to get ahead by completing or finalizing Florida licensing, so they're positioned for the next wave of assignments. This evergreen posting is ideal if you're already licensed in Florida or you're actively pursuing licensing and want time to complete the process so you're ready when assignments open. This position requires a Class C License, or eligibility to obtain Class C License (2 years of investigative experience, or 1 year of investigative experience with a Criminal Justice degree.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
Responsibilities/ Requirements
What You'll Do
As a Private Field Surveillance Investigator, you'll conduct discreet, vehicle-based surveillance to help uncover insurance fraud and deliver trusted results to our clients. Your work will include:
Case prep & research using social media and database tools to build a smart plan before you roll
Mobile and stationary surveillance while maintaining professionalism, discretion, and safety
High-quality video documentation that captures key activity clearly and consistently
Daily reporting and evidence submission (upload video and written reports from your personal laptop)
Communication with your field leadership for support, guidance, and case direction
What We're Looking For
Active Florida Class C License (preferred)
or
in the process of completing and obtaining an active Florida Class C License (Must have prior to start)
Prior surveillance / field investigations experience strongly preferred
Comfortable working independently, being on the road, and adapting quickly to changing case activity
Solid writing skills for clear, court-ready reporting
Tech-ready: able to upload video, submit reports, and follow digital case instructions reliably
Apply Today
If you're ready to take on surveillance assignments in Florida-now or soon-apply today. Qualified candidates may be contacted immediately for current opportunities and prioritized for upcoming needs.
Additional Responsibilities:
Duties and responsibilities include essential functions of positions assigned to this classification. Depending on assignment, the employee may perform a combination of some or all the following duties:
Conduct Fixed and Mobile Video Surveillance: Capture high-quality video footage of subjects to assist in case investigations.
Gather Evidence: Obtain videotaped documentation, photos, and audio recordings as part of thorough surveillance.
Background and Activity Checks: Perform courthouse research, background checks, and monitor subject activities to build robust case reports.
Investigative Reporting: Draft clear, concise, and detailed investigative reports summarizing findings and evidence.
Evidence Management: Upload all video, photographic, and audio evidence into the case management system in a timely and organized manner.
Drive Safely and Responsibly: Remain alert and practice safe driving while traveling to and from investigation sites.
Working Conditions:
Most surveillance cases start at 6:00AM. End time can vary depending on activity.
Weekends/holidays are common workdays as claimants are more likely to be active.
This is an independent role often requiring long hours alone in your vehicle, regardless of weather conditions.
Must remain alert with no external distractions, ready to use videography equipment to document subjects.
Benefits
Compensation & Perks That Work For You:
We believe great work deserves great rewards. Here's what you can expect when you join our team:
Competitive Pay:
Earn $25-$28 per hour, based on experience.
On-the-Road Support:
Monthly vehicle allowance
Company fuel card
Company-issued cell phone
Monthly internet stipend
Travel & report writing compensation
Fast, hassle-free expense reimbursements (minimal out-of-pocket costs)
Full Coverage Benefits:
Medical, dental, and vision insurance
Employer-paid life insurance, short-term & long-term disability
Future-Focused Perks:
Company-matching 401(k) to help you build for the future
Paid time off to recharge and reset
Company-paid investigator licensing fees
Career Growth:
Ongoing paid training and advancement opportunities to help you grow your skills and your career
The salary range for this role is $25-28 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
About Us:
CoventBridge Group is the global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge Group is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge Group is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
License #: A1000233
$25-28 hourly Auto-Apply 5d ago
Program Integrity Audit Analyst II
Coventbridge Group 3.8
Remote Coventbridge Group job
Program Integrity Audit Analyst II - REMOTE
The Program Integrity Audit Analyst II performs evaluation and development of leads associated with performance audits of Medicaid Managed Care Plans to identify potential fraud, waste, and abuse; issue findings and recommendations; and identify improper payments.
In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse.
This position will report directly to the Program Integrity Audit Supervisor and will work in our Grove City, OH office. If not local, remotely from a home office.
Responsibilities/ Requirements
Responsibilities:
Understanding of state Medicaid programs and managed care plan delivery systems.
Planning, coordinating, and conducting performance audits in accordance with Government Auditing Standards.
Understanding managed care encounter data and determining areas that require improved program integrity oversight.
Designing and implementing audit strategies for performing provider payment reviews and managed care plan performance audits using independent judgment to formulate a plan of action and direction in complex audit scenarios.
Work with auditors to develop audit plans clearly defining scope, steps, and tasks to achieve stated audit objectives including plans of action for audit development and information request processing.
Documenting specific findings and recommendations for improved contract compliance and process improvement; and identifying any improper payments with conclusions based on rule, policy, and billing instructions.
Developing and supporting findings that accurately report condition, criteria, cause, and effect and proposes viable recommendations for corrective actions, as applicable.
Prioritization and assignment of workload, ensuring adherence to task order policies and procedures.
Preparing factual and objective written reports in conformance with professional auditing and evaluation standards.
Ensure findings are well defined and are fully supportable and required reports are submitted according to pre-established time guidelines.
Interpret and apply pertinent laws, regulations, policies, and procedures relevant to the specific audit findings.
Conduct matrix review meetings with auditors to ensure thorough and timely completion of assigned audit tasks in accordance with task order guidelines and direction from CMS.
Prepare and submit medical record request letters to providers associated with requests for medical record requests or suspension overpayment determinations.
Serve as mentor/trainer to new Program Integrity staff.
Perform other duties as assigned by PI Audit Supervisor or the PI Manager, Deputy PI Manager, PI Project Manager, or Medicaid Operations Lead
Requirements:
Excellent research and organization, prioritization, and time management skills
Excellent verbal and written communication skills
Ability to work independently with minimal supervision
Ability to multi-task in a fast-paced environment
Knowledge of statistics, data analysis techniques, and PC skills are preferred
Experience with an inventory management and reporting system preferred
Proficiency with Microsoft Word and Excel required
Educational/Experience Qualifications:
High School Diploma or G.E.D. equivalent, with preference given to those candidates who have successfully completed college or technical degree programs related to the position (e.g., Criminal Justice, Statistics, Data Analysis, etc.)
Candidates with Certified Fraud Examiner (CFE) Certifications will be given priority consideration
Minimum of one (1) year of experience conducting performance or compliance audits, with preference given to those who have conducted audits involving state Medicaid programs, or one (1) year of experience with an advanced degree preferred
Benefits
Medical, Dental, Vision plans
Life, LTD and STD paid by the employer
401(k) with company match up to 4%
Paid Time Off and company paid holidays
Tuition assistance after 1 year of service
The salary range for this role is $60,000 to $70,000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
About Us:
CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
$60k-70k yearly Auto-Apply 5d ago
Video Technician- Full Time
Coventbridge Group 3.8
Coventbridge Group job in Jacksonville, FL
Video Production Specialist
Jackosnville, FL CoventBridge is seeking an entry level Video Production Specialist the Jacksonville area to join our Operations Team. The Video Production Specialist is primarily responsible for editing investigative reports, client correspondence, and videos provided by investigators. This position will report directly to the Production Manager.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
Responsibilities/ Requirements
Responsibilities:
Duties and responsibilities include essential functions of positions assigned to this classification. Depending on assignment, the employee may perform a combination of some or all the following duties:
Proofreading and editing investigative reports and client correspondence to ensure all text elements meet established quality standards for content, spelling, grammar, and punctuation
Converting video from tapes, discs or digital uploads to appropriate format to meet client needs
Reviewing surveillance video provided by investigators and comparing against investigative reports for time and accuracy
Editing reports as appropriate
Acquiring still photos and video clips obtained during investigations from media saving to case files and attach to reports
Utilizing databases and telephone to research data requirements for new cases, investigators, case managers, and data-only cases and print/post to the web
Interpreting research data for Surveillance Investigators and Case Managers
Composing letters to clients for video copy assignments and providing verbal or e-mail updates as specified
Requirements:
Excellent report writing, editing and proofreading skills
Strong organizational/time management skills
Strong verbal and written communication skills
Strong Computer and Internet Skills Including Microsoft Office
Self-starter who takes on challenging responsibilities and holds self-accountable for results and performance.
Strong attention to detail with commitment to accuracy and quality while meeting goals or deadlines.
Highest level of integrity
Commitment to excellence
Educational/Experience Qualifications:
Associates degree (A.A.) or equivalent from two-year college or technical school preferred)
or one year related experience and/or training
or equivalent combination of education and experience.
Experience in an investigative environment a plus
Benefits
Medical, Dental, Vision plans
Life, LTD and STD paid by the employer
401(k) with company match up to 4%
Paid Time Off and company paid holidays
Tuition assistance after 1 year of service
Company paid training
The salary range for this role is $15 - $17 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
About Us:
CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
IND123
$15-17 hourly Auto-Apply 5d ago
Entry Level Business Development / Sales Associate
Advantage Surveillance LLC 3.6
Remote job
For the past 27 years, Advantage Investigations has been the Nation's only insurance defense investigation firm that invests in the operational capabilities necessary to produce consistent, high-quality results-ultimately helping our clients "See What's True."
With over 250 licensed private investigators Nationwide, Advantage uses strategic planning and technology to give our clients greater clarity in a claimant's daily activities. Providing Covert Surveillance, Claims Investigations, Net-Sweep Investigations, RCS and more, we're able to save our clients time and money on insurance fraud cases.
Advantage Investigations is seeking an entry level Business Development/Sales Associate. We are looking for a recent college graduate with a strong desire to learn our industry and work in our fast-paced environment. This position would report directly to our SVP of National Sales and Business Development. A Business Development/Sales Associate should work to generate new business opportunities by identifying, contacting, and following up with potential customers within our industry. In this position, you will build a network of potential clients as directed by the SVP of Sales, attend industry conferences and events, and create and deliver presentations for potential clients. The Business Development/Sales Associate will maintain our sales department's pipeline and record ROI. This is a full time, exempt, remote position.
Duties & Responsibilities:
Attend conferences, client meetings, and social events as directed
Set up conference booths, displays, and accompanying swag
Identify potential customers as directed through research, conferences, emails, social media and sales pipelines and conduct outreach
Evaluate qualified leads to ensure their needs can be met with our services
Collaborate with sales representatives and leaders to ensure alignment on target prospects
Track and report sales KPIs within CRM
Create and deliver presentations highlighting and messaging company's service offerings
Stay up to date on industry developments, market trends and any new service offerings
Lead and complete additional projects as assigned
Qualifications & Requirements:
Bachelor's degree in marketing or business administration
Strong desire to learn investigative industry
Up to 50% travel
Proven track record to complete tasks, take directions, and work in a team environment
Demonstrated ability to lead with integrity, prioritize effectively, and thrive in a fast-paced environment
Organized, dependable, and detail-oriented
Strong written and verbal communication skills
Compensation: $65,000 - 70,000 (commensurate with experience and qualifications). Employees are paid on a bi-weekly basis.
Company Benefits / What we Offer:
Competitive salary, and growth opportunity
High-impact role with direct access to senior leadership
A collaborative and entrepreneurial work environment
2 weeks paid PTO + paid holidays
Medical, Dental, Vision, Life, STD, LTD, HSA, DCFSA, Accident, Cancer, Critical Illness, Pet insurance
401k with 2% match
Advantage Investigations is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
#ZR
$65k-70k yearly Auto-Apply 49d ago
Accident Reconstructionist
Advantage Surveillance LLC 3.6
Remote job
For the past 27 years, Advantage Investigations has been the Nation's only insurance defense investigation firm that invests in the operational capabilities necessary to produce consistent, high-quality results-ultimately helping our clients "See What's True."
With over 200 licensed private investigators Nationwide, Advantage uses strategic planning and technology to give our clients greater clarity on a claimant's daily activities. Providing Covert Surveillance, Claims Investigations, Net-Sweep Investigations, RCS and more, we're able to save our clients time and money on insurance fraud cases.
Advantage Investigations is seeking a Part-Time Vehicle Accident Reconstructionist. This position will be an hourly remote position with minimal travel required. The qualified candidate will be responsible for reviewing the accident reconstruction data for singular and multiple vehicle collisions in support of client objectives and quality standards.
Duties & Responsibilities:
Reconstructing vehicular accidents using engineering analysis, CAE- Base tools, scene investigation data, photos, video, CDR/EDR downloads etc.
Perform speed, damage analysis, response times, time-distance relationships
Utilizes engineering principles and momentum equations to calculate factors such as impact and departure speeds, collision forces, trajectories of the vehicles, traffic signal, intersection analysis etc.
Vehicle braking efficiency of air brake systems on commercial motor vehicles
Compare calculations with crash test reports of similar collisions to correlate damages
Accurately analyze crash patterns to provide written conclusions to determine factors contributing to the accidents
Manages project resources and sets/meets deadlines to ensure that projects stay on schedule.
Timely, accurate analysis, prepare reports, and present your findings to the client(s)
prepare and present demonstrative diagrams and charts, and provide an analysis of the cause of various incidents
Preparing concise written reports of analysis and conclusions
Provide collision scene investigation analysis and forensic mapping of collision sites and vehicles
Inspect cars, trucks, and other various forms of transportation via photos and videos provided
Ability to manage several investigations simultaneously, so organizational skills and attention to detail are essential
Experience with investigation reports
Provide testimony at depositions or trials
Qualifications & Requirements:
5 years of Accident Reconstruction experience
Prior law enforcement accident reconstruction experience preferred
4 years of experience working with insurance carriers, attorneys, and/or adjusters
Mechanical Engineering degree a plus
Event Data Recorder (EDR) Certified a plus
Mechanical Engineers experience a plus
ACTAR certification or the ability to obtain in a specified time frame
Solid analytical skills
Excellent time management, organizational, and attention to detail skills
Strong communication skills both verbally and written
Proficiency in statistics
Compensation: Accident Reconstructionist are paid an hourly rate commensurate with experience within $45.00 to $55.00 an hour. Employees are paid on a bi-weekly basis.
Company Benefits:
Competitive hourly pay
401k with match
Flexible Schedule
Advantage Investigations is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
$45-55 hourly Auto-Apply 60d+ ago
Medicare Medical Review RN (Medical Reviewer III)
Coventbridge Group 3.8
Remote Coventbridge Group job
Medicare Medical Review RN (Medical Reviewer III) - REMOTE
* RN license required to be eligible*
The Medicare Medical Review RN (Medical Reviewer III) will primarily be responsible for conducting clinical reviews of medical records during the course of fraud investigations or other program integrity initiatives such as requests for information or in support of proactive data analysis efforts. In addition, this position applies Medicare and Medicaid guidelines in making clinical determinations as to the appropriateness of payment coverage.
In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse.
This position will report directly to the Medical Review Supervisor and will work in our Grove City, OH office. If not local, remotely from a home office.
Responsibilities/ Requirements
Responsibilities:
Reviews information contained in Standard Claims Processing System files (e.g., claims history, provider files) to determine provider billing patterns and to detect potentially fraudulent or abusive billing practices or vulnerabilities in Medicare or Medicaid payment policies
Utilizes extensive knowledge of medical terminology, ICD-9-CM, ICD-10-CM HCPCS Level II and CPT coding along with analysis and processing of Medicare claims. Utilizes Medicare/Medicaid and Contractor guidelines for coverage determinations
Coordinates and compiles the written Investigative Summary Report to the PI Investigator upon completion of the records review
Incorporates leadership and communication skills to work with physicians and other health professionals as well as external regulatory agencies and law enforcement personnel
Provides training to UPIC staff on medical terminology, reading medical records, and policy interpretation
Provides expert witness testimony as required
Completes assignments in a manner that meets or exceeds the quality assurance goal of 98% accuracy
Maintains chain of custody on all documents and follows all confidentiality and security guidelines
Performs other duties as assigned by the Medical Review Supervisor that contribute to UPIC goals and objectives and comply with the Program Integrity Manual and Statement of Work guidelines and CMS directives and regulations
Requirements:
2 years minimum experience at a government contractor (ZPIC, UPIC, RAC, MAC, etc.)
2 years minimum working knowledge of ICS 10-CM/CPT coding experience
4 years minimum experience of working knowledge of Diagnosis Related Groups (DRG's), Prospective Payment Systems or Part B claims and Medicare coverage guidelines
Knowledge of, and the ability to correctly identify, Medicare and Medicaid coverage guidelines
Advance knowledge of medical terminology and experience in the analysis and processing of Medicare claims, utilization review/ quality assurance procedures, ICD 10-CM and CPT coding, Medicare coverage guidelines and payment methodologies (i.e., Correct Coding Initiative, DRG's, Prospective Payment Systems and Ambulatory Surgical center), NCPCP and other types of prescription drug claims
Ability to read Medicare claims, both paper and electronic, and a basic knowledge of the Medicare claims systems is required
Should possess excellent oral and written communication skills with an ability to write professional summary reports
Knowledge of and ability to use Microsoft Word, Excel, and Internet applications
Able to efficiently organize and manage workload and assignments
Must have and maintain a valid driver' license for the associate's state of residence as onsite audits are part of the role as a nurse reviewer
Educational/Experience Qualifications:
Graduate from an accredited school of nursing and have an active license as a Registered Nurse (RN) required
Preference given to BSN or higher prepared nurses with recent medical review claims experience in Medicare or Medicaid reviews
Benefits
Medical, Dental, Vision plans
Life, LTD and STD paid by the employer
401(k) with company match up to 4%
Paid Time Off and company paid holidays
Tuition assistance after 1 year of service
The salary range for this role is $65,000 to $75,000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
About Us:
CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
$65k-75k yearly Auto-Apply 13d ago
SIU Investigator
Advantage Surveillance LLC 3.6
Miami, FL job
For the past 27 years, Advantage Investigations has been the Nation's only insurance defense investigation firm that invests in the operational capabilities necessary to produce consistent, high-quality results-ultimately helping our clients "See What's True."
With over 200 licensed private investigators Nationwide, Advantage uses strategic planning and technology to give our clients greater clarity on a claimant's daily activities. Providing Covert Surveillance, Claims Investigations, Net-Sweep Investigations, RCS and more, we're able to save our clients time and money on insurance fraud cases.
Advantage Investigations is seeking a Part-Time SIU/Claims Investigator in Miami , FL/Surrounding Areas . The qualified candidate will be responsible for conducting investigations of auto, property, homeowner liability and worker's compensation insurance claims in support of client objectives and company quality standards. As a Claims Investigator, you will be provided with a comprehensive training program, door to door pay, and mileage reimbursement at the IRS rate. This position requires daily travel within the investigator's area/territory.
**Current FL Private Investigator License preferred**
Duties & Responsibilities:
Conduct investigations of auto, property, liability, and worker's compensation claims
Independently reviews the assignment, supporting documentation and all other case information prior to commencing the on-site assignment.
Consults with the Manager on appropriate strategies for individual cases, before and throughout the investigative process.
Locate subjects of the assigned investigation and conduct applicable case investigation, to include alive and well checks, recorded statements, and scene investigations etc.
Creates and maintains written daily updates, supporting photos, audiotapes, diagrams, and final investigative reports for in a timely and professional manner
Time management and communication skills
Ability to handle confidential information and material
Qualifications & Requirements:
3 years insurance claims investigative experience required
Investigation experience or relatable experience preferred
Bi-Lingual in Spanish preferred
Current FL Private Investigator License preferred
Full comprehension of case management systems
Able to proactively conduct follow-ups as needed
Good Oral and Written Communication Skills
Proficient in computer technology - including Microsoft office type products, email, and the ability to produce quality, well-written reports
Self-Starter/Disciplined work ethic with ability to ask relevant questions when needed, and work indecently
Daily access to a reliable vehicle
Valid Driver's License
Pass Drug Screen
Compensation: Investigators are paid door to door an hourly rate commensurate with experience within $28.00 to $32.00 an hour. Employees are paid on a bi-weekly basis.
Company Benefits:
Door to Door hourly pay
Mileage Reimbursement at IRS rate
401k with match
Flexible Schedule
Advantage Investigations is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
$28-32 hourly Auto-Apply 33d ago
Medicaid/Medicare Program Integrity Analyst II
Coventbridge Group 3.8
Remote Coventbridge Group job
Medicaid/Medicare Program Integrity Analyst II - REMOTE
The Medicaid/Medicare Program Integrity Analyst II performs evaluation and development of leads, complaints, and/or investigations to verify allegations of potential fraud. Recommends and/or implements appropriate administrative actions.
In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse.
This position will report directly to the Program Integrity Supervisor and will work in our Grove City, OH office, or if not local, remotely from a home office.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
Responsibilities/ Requirements
Responsibilities:
Perform evaluation and development of leads, complaints, and/or investigations to determine if further investigation and administrative actions are warranted
Conduct independent reviews resulting from the discovery of situations that potentially involve fraud or abuse
Utilize basic data analysis techniques to detect aberrancies in Medicare and Medicaid claims data, and proactively seeks out and develops leads/investigations received from a variety of sources (e.g., CMS, OIG, 1-800-MEDICARE, and fraud alerts)
Review information contained in standard claims processing system files (e.g., claims history, provider files) to determine provider billing patterns and to detect potential fraudulent or abusive billing practices or vulnerabilities in Medicare and Medicaid policies and initiate appropriate action
Make potential fraud determinations by utilizing a variety of sources such as internal guidelines, Medicare and Medicaid provider manuals, Medicare and Medicaid regulations, and the Social Security Act
Compile and maintain documentation and information related to investigations, cases, and/or leads
Participate in onsite audits in conjunction with investigation development
Develop and prepare potential Fraud Alerts and program vulnerabilities for submission to CMS. Share information on current fraud investigations with other Medicare contractors and state Medicaid agencies, law enforcement, and other applicable stakeholders
Prepare and submit external correspondence and reports, including, but not limited to, overpayment letters, fraud case referrals, suspensions, rebuttals, Medicare/Medicaid findings reports, and administrative action recommendations
Submit suspension notifications to providers upon suspension approval
Prepare and submit ADR letters to providers associated with requests for medical record requests or suspension overpayment determinations
Serve as mentor/trainer to new Program Integrity staff
Perform other duties as assigned by PI Supervisor or PI Manager that contribute to task order goals and objectives
Requirements:
Excellent research and organization, prioritization, and time management skills
Excellent verbal and written communication skills
Ability to work independently with minimal supervision
Ability to multi-task in a fast-paced environment
Knowledge of statistics, data analysis techniques, and PC skills are preferred
Educational/Experience Qualifications:
High School Diploma or G.E.D. equivalent, with preference given to those candidates who have successfully completed college or technical degree programs related to the position (e.g., Criminal Justice, Statistics, Data Analysis, etc.)
Candidates with Certified Fraud Examiner (CFE) Certifications will be given priority consideration
At least 1 year of experience in Program Integrity investigation/detection or a related field that demonstrates expertise in reviewing, analyzing/developing information, and making appropriate decisions
Benefits
Medical, Dental, Vision plans
Life, LTD and STD paid by the employer
401(k) with company match up to 4%
Paid Time Off and company paid holidays
Tuition assistance after 1 year of service
The salary range for this role is $60,000 to $70,000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
About Us:
CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
$60k-70k yearly Auto-Apply 22d ago
Private Investigator - Company Vehicle Provided!
Photofax 2.7
Tampa, FL job
Job DescriptionSalary: $20-$25
Private Investigator - Company Vehicle Provided!
PhotoFax, Inc., a nationwide private detective agency, is currently hiring surveillance investigators to join our team in the Tampa, FLregion.
If you like to work autonomously in dynamic environments, surveillance investigations provide an exciting career path meant just for you! Join the PhotoFax team today and we provide the tools necessary to start your career as a Private Investigator.
What your day will look like:
Monitoring, pursuing, and documenting individuals in a covert manner from a company issued-fully customized surveillance vehicle
Pre and post surveillance briefing with your case manager to discuss objectives, surveillance tactics, and case details
Detailed reporting on daily case observations
Uploading video evidence obtained to the company database
Occasional Regional Travel (in the company issued vehicle)
View our recruiting video:https://vimeo.com/323***********b7a16e
What you will gain:
Experience that will lead to other opportunities in:
Investigations
Law enforcement
Upper claims management
Growth within PhotoFax
A company issued vehicle customized for surveillance and all equipment necessary to do the job
Hands on training with our experienced trainers with 34 years of investigative knowledge
Full health benefits package including matching 401K
Performance based reviews and bonuses
Paid overtime and travel
What you need to apply:
High school diploma
Associates/Bachelor's degree in Criminal Justice/Criminology/Law Enforcement preferred
Valid driver's license
Clean driving record with minimal infractions
Must currently reside in the greater Tampa, FL area
Flexibility to work any day of the week including weekends and holidays
Willingness to travel with occasional overnight stays
No previous experience is necessary; we provide all training and licensing
$20-25 hourly 17d ago
Surveillance Investigator
Frasco 4.1
Tampa, FL job
Full-time Description
Job Title: Surveillance Investigator
Job Type: Full-Time, Billable Hours, Non-exempt
Eager to start your career in a growing industry? Get paid to learn the ropes of fraud investigation and real-world surveillance. Frasco offers fully paid investigator training to help you launch your career!
Is surveillance right for you? Watch this: ****************************
Compensation:
Hourly Rate: $20 - $24 per hour (Weekly Pay), Commensurate with experience and performance
Travel Time: Travel commute time is compensated at 100% of regular hourly rate, after standard commute deduction
Mileage Reimbursement: $0.50 per mile for all portal-to-portal and mobile surveillance mileage
Paid Administrative Time: Paid at regular hourly rate (report writing, administrative time, etc.)
Paid Training: Paid at regular hourly rate
Full-Time Benefits:
Paid Time Off and Paid Holidays
Health, Dental, Vision, Employer Paid Life Insurance, Supplemental Health Benefits, Flexible Spending Accounts
401K with Company Match
About Us: Frasco has been in business for 60 years as a family-owned full-service investigation company with hundreds of investigators and regional office nationwide. Our vibrant company culture, driven by core values of integrity, innovation, and excellence, fosters a supportive and collaborative environment where every individual is valued. We are committed to diversity and inclusion, encouraging applications from all backgrounds. Join us to make a meaningful impact and thrive in a positive, respectful workplace.
Responsibilities:
Review assignments to determine case objectives and develop or follow action plans
Utilize various surveillance equipment and technology
Perform surveillance and activity checks, documenting video footage and relevant information
Conduct surveillance indoors and outdoors, involving extended periods of walking, standing, or sitting
Drive safely and effectively in varied weather and traffic conditions
Move swiftly and discreetly to observe subjects
Maintain high standards of communication and confidentiality, adhering to ethical and legal guidelines
Prepare detailed reports with timestamps and supporting evidence for legal use
Adapt to changing circumstances and work flexible hours, including nights, weekends, and holidays
Attend and testify at hearings as required
Requirements
Requirements:
Exceptional writing and communication skills
Strong attention to detail and commitment to accuracy and quality
Ability to work independently and meet established deadlines
Strong critical thinking skills
Self-starter with accountability for results and performance
Flexible schedule, including weekends
Ability to travel to and from assignments daily
Must possess/obtain a Class C or CC Florida investigator license
Qualifications and Equipment:
Valid driver's license with a good driving record
Minimum Auto Insurance Coverage: $100,000 per person, $300,000 per accident bodily injury, and $50,000 property damage
Reliable personal vehicle,
tinted windows preferred
HD camcorder, covert camera, smartphone, computer or laptop, and internet connectivity
Windows 11 or greater required, with 8+gb of RAM preferred
Mac OSX 13 or greater required for iMac
Preferred Experience:
High school diploma or associate's degree in criminal justice or related field
Military background; insurance or investigations experience
Start your career with a leader in the investigations industry that is financially stable, is experiencing growth, and whose history spans over 60 years!
Ready to make a difference? Apply now!All replies are confidential Equal Opportunity Employer
PM18
$20-24 hourly 7d ago
SIU Investigator
Advantage Surveillance LLC 3.6
Miami, FL job
Job Description
For the past 27 years, Advantage Investigations has been the Nation's only insurance defense investigation firm that invests in the operational capabilities necessary to produce consistent, high-quality results-ultimately helping our clients "See What's True."
With over 200 licensed private investigators Nationwide, Advantage uses strategic planning and technology to give our clients greater clarity on a claimant's daily activities. Providing Covert Surveillance, Claims Investigations, Net-Sweep Investigations, RCS and more, we're able to save our clients time and money on insurance fraud cases.
Advantage Investigations is seeking a Part-Time SIU/Claims Investigator in Miami, FL/Surrounding Areas. The qualified candidate will be responsible for conducting investigations of auto, property, homeowner liability and worker's compensation insurance claims in support of client objectives and company quality standards. As a Claims Investigator, you will be provided with a comprehensive training program, door to door pay, and mileage reimbursement at the IRS rate. This position requires daily travel within the investigator's area/territory.
**Current FL Private Investigator License preferred**
Duties & Responsibilities:
Conduct investigations of auto, property, liability, and worker's compensation claims
Independently reviews the assignment, supporting documentation and all other case information prior to commencing the on-site assignment.
Consults with the Manager on appropriate strategies for individual cases, before and throughout the investigative process.
Locate subjects of the assigned investigation and conduct applicable case investigation, to include alive and well checks, recorded statements, and scene investigations etc.
Creates and maintains written daily updates, supporting photos, audiotapes, diagrams, and final investigative reports for in a timely and professional manner
Time management and communication skills
Ability to handle confidential information and material
Qualifications & Requirements:
3 years insurance claims investigative experience required
Investigation experience or relatable experience preferred
Bi-Lingual in Spanish preferred
Current FL Private Investigator License preferred
Full comprehension of case management systems
Able to proactively conduct follow-ups as needed
Good Oral and Written Communication Skills
Proficient in computer technology - including Microsoft office type products, email, and the ability to produce quality, well-written reports
Self-Starter/Disciplined work ethic with ability to ask relevant questions when needed, and work indecently
Daily access to a reliable vehicle
Valid Driver's License
Pass Drug Screen
Compensation: Investigators are paid door to door an hourly rate commensurate with experience within $28.00 to $32.00 an hour. Employees are paid on a bi-weekly basis.
Company Benefits:
Door to Door hourly pay
Mileage Reimbursement at IRS rate
401k with match
Flexible Schedule
Advantage Investigations is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
$28-32 hourly 3d ago
Surveillance Investigator
Frasco 4.1
Lake Worth, FL job
Job Title: Surveillance Investigator
Job Type: Full-Time, Billable Hours, Non-exempt
Eager to start your career in a growing industry? Get paid to learn the ropes of fraud investigation and real-world surveillance. Frasco offers fully paid investigator training to help you launch your career!
Is surveillance right for you? Watch this: ****************************
Compensation:
Hourly Rate: $20 - $26 per hour (Weekly Pay) Commensurate with experience and performance
Travel Time: Travel commute time is compensated at 100% of regular hourly rate, after standard commute deduction
Mileage Reimbursement: $0.50 per mile for all portal-to-portal and mobile surveillance mileage
Paid Administrative Time: Paid at regular hourly rate (report writing, administrative time, etc.)
Paid Training: Paid at regular hourly rate
Full-Time Benefits:
Paid Time Off and Paid Holidays
Health, Dental, Vision, Employer Paid Life Insurance, Supplemental Health Benefits, Flexible Spending Accounts
401K with Company Match
About Us:
Frasco has been in business for 60 years as a family-owned full-service investigation company with hundreds of investigators and regional office nationwide. Our vibrant company culture, driven by core values of integrity, innovation, and excellence, fosters a supportive and collaborative environment where every individual is valued. We are committed to diversity and inclusion, encouraging applications from all backgrounds. Join us to make a meaningful impact and thrive in a positive, respectful workplace.
Responsibilities:
Review assignments to determine case objectives and develop or follow action plans
Utilize various surveillance equipment and technology
Perform surveillance and activity checks, documenting video footage and relevant information
Conduct surveillance indoors and outdoors, involving extended periods of walking, standing, or sitting
Drive safely and effectively in varied weather and traffic conditions
Move swiftly and discreetly to observe subjects
Maintain high standards of communication and confidentiality, adhering to ethical and legal guidelines
Prepare detailed reports with timestamps and supporting evidence for legal use
Adapt to changing circumstances and work flexible hours, including nights, weekends, and holidays
Attend and testify at hearings as required
Requirements
Job Requirements
Requirements:
Exceptional writing and communication skills
Strong attention to detail and commitment to accuracy and quality
Ability to work independently and meet established deadlines
Strong critical thinking skills
Self-starter with accountability for results and performance
Flexible schedule, including weekends
Ability to travel to and from assignments daily
Must possess a Florida Class C or CC investigator license
Qualifications and Equipment:
Valid driver's license with good driving record
Minimum Auto Insurance Coverage: $100,000 per person, $300,000 per accident bodily injury, and $50,000 property damage
Reliable personal vehicle,
tinted windows preferred
HD camcorder, covert camera, smartphone, computer or laptop, and internet connectivity
Windows 11 or greater required, with 8+gb of RAM preferred
Mac OSX 13 or greater required for iMac
Preferred Experience:
High school diploma or associate's degree in criminal justice or related field
Military background; insurance or investigations experience
Start your career with a leader in the investigations industry that is financially stable, is experiencing growth, and whose history spans over 60 years!
Ready to make a difference? Apply now!All replies are confidential Equal Opportunity EmployerPM18
$20-26 hourly 60d+ ago
SIU Investigator
Advantage Surveillance LLC 3.6
Miami, FL job
For the past 27 years, Advantage Investigations has been the Nation's only insurance defense investigation firm that invests in the operational capabilities necessary to produce consistent, high-quality results-ultimately helping our clients "See What's True."
With over 200 licensed private investigators Nationwide, Advantage uses strategic planning and technology to give our clients greater clarity on a claimant's daily activities. Providing Covert Surveillance, Claims Investigations, Net-Sweep Investigations, RCS and more, we're able to save our clients time and money on insurance fraud cases.
Advantage Investigations is seeking a Part-Time SIU/Claims Investigator in Miami, FL/Surrounding Areas. The qualified candidate will be responsible for conducting investigations of auto, property, homeowner liability and worker's compensation insurance claims in support of client objectives and company quality standards. As a Claims Investigator, you will be provided with a comprehensive training program, door to door pay, and mileage reimbursement at the IRS rate. This position requires daily travel within the investigator's area/territory.
**Current FL Private Investigator License preferred**
Duties & Responsibilities:
Conduct investigations of auto, property, liability, and worker's compensation claims
Independently reviews the assignment, supporting documentation and all other case information prior to commencing the on-site assignment.
Consults with the Manager on appropriate strategies for individual cases, before and throughout the investigative process.
Locate subjects of the assigned investigation and conduct applicable case investigation, to include alive and well checks, recorded statements, and scene investigations etc.
Creates and maintains written daily updates, supporting photos, audiotapes, diagrams, and final investigative reports for in a timely and professional manner
Time management and communication skills
Ability to handle confidential information and material
Qualifications & Requirements:
3 years insurance claims investigative experience required
Investigation experience or relatable experience preferred
Bi-Lingual in Spanish preferred
Current FL Private Investigator License preferred
Full comprehension of case management systems
Able to proactively conduct follow-ups as needed
Good Oral and Written Communication Skills
Proficient in computer technology - including Microsoft office type products, email, and the ability to produce quality, well-written reports
Self-Starter/Disciplined work ethic with ability to ask relevant questions when needed, and work indecently
Daily access to a reliable vehicle
Valid Driver's License
Pass Drug Screen
Compensation: Investigators are paid door to door an hourly rate commensurate with experience within $28.00 to $32.00 an hour. Employees are paid on a bi-weekly basis.
Company Benefits:
Door to Door hourly pay
Mileage Reimbursement at IRS rate
401k with match
Flexible Schedule
Advantage Investigations is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
$28-32 hourly Auto-Apply 31d ago
Surveillance Investigator - Experienced- Full Time
Coventbridge Group 3.8
Coventbridge Group job in Pensacola, FL
Surveillance Investigator - Experienced- Full Time
Pensacola, FL Area
Now Hiring: Private Field Surveillance Investigator
CoventBridge Group is growing-and we're looking for experienced, licensed investigators to join our elite surveillance team. In this role, you'll conduct discreet, vehicle-based field investigations to help uncover insurance fraud and deliver trusted results to our clients.
As a leader in the fraud investigation industry, CoventBridge Group offers the opportunity to work remotely utilizing advanced tools, and the support of a nationwide team.
Ready to make an impact? Join the best in the business and apply today.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
Responsibilities/ Requirements
Key Responsibilities:
Case Prep: Use social media and database tools to conduct initial research and gather intel on subjects.
Surveillance in the Field: Carry out discreet, mobile and stationary surveillance-track movements and capture high-quality video evidence.
Reporting: Write thorough, court-ready reports that clearly document key activities and findings.
Evidence Submission: Wrap up each day by uploading reports and video footage from your personal laptop.
Team Collaboration: Stay connected with your field supervisor for ongoing support, guidance, and mentorship.
Essentials for this Role:
PI License: Must currently hold a Florida Private Investigator license(Class C).
Driver's License: Active driver's license that is not currently suspended or revoked.
Personal Vehicle: A well-maintained vehicle that is always reliable (preferably with tinted windows). Proof of auto insurance coverage is required.
Travel Expectations: While we aim to keep assignments within a reasonable drive of your residence, occasional further travel and overnight stays (covered by the company) may be required.
Technology: A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks.
Required Skills: Strong computer & internet proficiency. Excellent communication, verbal & writing skills. Possess or is willing to purchase covert camera, digital video camera with uploading capabilities, and laptop computer with Windows Operating System with access to Microsoft Word
Key Responsibilities:
Duties and responsibilities include essential functions of positions assigned to this classification. Depending on assignment, the employee may perform a combination of some or all the following duties:
Conduct Fixed and Mobile Video Surveillance: Capture high-quality video footage of subjects to assist in case investigations.
Gather Evidence: Obtain videotaped documentation, photos, and audio recordings as part of thorough surveillance.
Background and Activity Checks: Perform courthouse research, background checks, and monitor subject activities to build robust case reports.
Investigative Reporting: Draft clear, concise, and detailed investigative reports summarizing findings and evidence.
Evidence Management: Upload all video, photographic, and audio evidence into the case management system in a timely and organized manner.
Drive Safely and Responsibly: Remain alert and practice safe driving while traveling to and from investigation sites.
Working Conditions:
Most surveillance cases start at 6:00AM. End time can vary depending on activity.
Weekends/holidays are common workdays as claimants are more likely to be active.
This is an independent role often requiring long hours alone in your vehicle, regardless of weather conditions.
Must remain alert with no external distractions, ready to use videography equipment to document subjects.
Benefits
Compensation & Perks That Work For You:
We believe great work deserves great rewards. Here's what you can expect when you join our team:
Competitive Pay:
On-the-Road Support:
Monthly vehicle allowance
Company fuel card
Company-issued cell phone
Monthly internet stipend
Travel & report writing compensation
Fast, hassle-free expense reimbursements (minimal out-of-pocket costs)
Future-Focused Perks:
Company-matching 401(k) to help you build for the future
Company-paid investigator licensing fees
Career Growth:
Ongoing paid training and advancement opportunities to help you grow your skills and your career
About Us:
CoventBridge Group is the global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge Group is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge Group is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
CoventBridge (USA) Inc. Florida License # A1000233
IND123
$37k-56k yearly est. Auto-Apply 41d ago
Private Investigator - Company Vehicle Provided!
Photofax 2.7
Tampa, FL job
PhotoFax, Inc., a nationwide private detective agency, is currently hiring surveillance investigators to join our team in the Tampa, FL region.
If you like to work autonomously in dynamic environments, surveillance investigations provide an exciting career path meant just for you! Join the PhotoFax team today and we provide the tools necessary to start your career as a Private Investigator.
What your day will look like:
Monitoring, pursuing, and documenting individuals in a covert manner from a company issued-fully customized surveillance vehicle
Pre and post surveillance briefing with your case manager to discuss objectives, surveillance tactics, and case details
Detailed reporting on daily case observations
Uploading video evidence obtained to the company database
Occasional Regional Travel (in the company issued vehicle)
View our recruiting video: https://vimeo.com/323***********b7a16e
What you will gain:
Experience that will lead to other opportunities in:
Investigations
Law enforcement
Upper claims management
Growth within PhotoFax
A company issued vehicle customized for surveillance and all equipment necessary to do the job
Hands on training with our experienced trainers with 34 years of investigative knowledge
Full health benefits package including matching 401K
Performance based reviews and bonuses
Paid overtime and travel
What you need to apply:
High school diploma
Associates/Bachelor's degree in Criminal Justice/Criminology/Law Enforcement preferred
Valid driver's license
Clean driving record with minimal infractions
Must currently reside in the greater Tampa, FL area
Flexibility to work any day of the week including weekends and holidays
Willingness to travel with occasional overnight stays
No previous experience is necessary; we provide all training and licensing
$29k-49k yearly est. 60d+ ago
Surveillance Investigator
Coventbridge Group 3.8
Coventbridge Group job in Miami, FL
Now Building Our Florida Bench: Private Field Surveillance Investigator (Current and Future Openings)
Location: Miami, FL (field-based) | Type: Independent/Field Investigations (Surveillance) | Schedule: Flexible
CoventBridge Group is growing-and we're hiring now while also building our pipeline for upcoming surveillance needs across Florida. This is a great opportunity for experienced investigators who are ready to take cases today, as well as professionals who want to get ahead by completing or finalizing Florida licensing, so they're positioned for the next wave of assignments. This evergreen posting is ideal if you're already licensed in Florida or you're actively pursuing licensing and want time to complete the process so you're ready when assignments open. This position requires a Class C License, or eligibility to obtain Class C License (2 years of investigative experience, or 1 year of investigative experience with a Criminal Justice degree.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
Responsibilities/ Requirements
What You'll Do
As a Private Field Surveillance Investigator, you'll conduct discreet, vehicle-based surveillance to help uncover insurance fraud and deliver trusted results to our clients. Your work will include:
Case prep & research using social media and database tools to build a smart plan before you roll
Mobile and stationary surveillance while maintaining professionalism, discretion, and safety
High-quality video documentation that captures key activity clearly and consistently
Daily reporting and evidence submission (upload video and written reports from your personal laptop)
Communication with your field leadership for support, guidance, and case direction
What We're Looking For
Active Florida Class C License (preferred)
or
in the process of completing and obtaining an active Florida Class C License
Prior surveillance / field investigations experience strongly preferred
Comfortable working independently, being on the road, and adapting quickly to changing case activity
Solid writing skills for clear, court-ready reporting
Tech-ready: able to upload video, submit reports, and follow digital case instructions reliably
Apply Today
If you're ready to take on surveillance assignments in Florida-now or soon-apply today. Qualified candidates may be contacted immediately for current opportunities and prioritized for upcoming needs.
Additional Responsibilities:
Duties and responsibilities include essential functions of positions assigned to this classification. Depending on assignment, the employee may perform a combination of some or all the following duties:
Conduct Fixed and Mobile Video Surveillance: Capture high-quality video footage of subjects to assist in case investigations.
Gather Evidence: Obtain videotaped documentation, photos, and audio recordings as part of thorough surveillance.
Background and Activity Checks: Perform courthouse research, background checks, and monitor subject activities to build robust case reports.
Investigative Reporting: Draft clear, concise, and detailed investigative reports summarizing findings and evidence.
Evidence Management: Upload all video, photographic, and audio evidence into the case management system in a timely and organized manner.
Drive Safely and Responsibly: Remain alert and practice safe driving while traveling to and from investigation sites.
Working Conditions:
Most surveillance cases start at 6:00AM. End time can vary depending on activity.
Weekends/holidays are common workdays as claimants are more likely to be active.
This is an independent role often requiring long hours alone in your vehicle, regardless of weather conditions.
Must remain alert with no external distractions, ready to use videography equipment to document subjects.
Benefits
Compensation & Perks That Work For You:
We believe great work deserves great rewards. Here's what you can expect when you join our team:
Competitive Pay:
Earn $25-$28 per hour, based on experience.
On-the-Road Support:
Monthly vehicle allowance
Company fuel card
Company-issued cell phone
Monthly internet stipend
Travel & report writing compensation
Fast, hassle-free expense reimbursements (minimal out-of-pocket costs)
Full Coverage Benefits:
Medical, dental, and vision insurance
Employer-paid life insurance, short-term & long-term disability
Future-Focused Perks:
Company-matching 401(k) to help you build for the future
Paid time off to recharge and reset
Company-paid investigator licensing fees
Career Growth:
Ongoing paid training and advancement opportunities to help you grow your skills and your career
The salary range for this role is $25-$28 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
About Us:
CoventBridge Group is the global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge Group is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge Group is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
License #: A1000233
$25-28 hourly Auto-Apply 5d ago
Private Investigator / SIU (Part-Time)
Photofax 2.7
Miami, FL job
Private Investigator Part-Time / Experienced (Miami, FL)
PhotoFax, Inc., a nationwide private detective agency, is currently hiring experienced surveillance investigators with SIU (Special Investigations Unit) experience to join our team in the Miami, FL region.
This position is designed for investigators with a background in insurance fraud or liability investigations who want flexible, part-time work with a professional agency. Candidates must have prior SIU and insurance claims investigation experience to be considered.
What your day will look like:
Monitoring, pursuing, and documenting individuals in a covert manner using your own vehicle
Conducting pre- and post-surveillance briefings with your case manager to review objectives and strategy
Preparing detailed reports on daily observations and findings
Uploading video and written documentation to the company database
Traveling within the surrounding Miami area (up to two hours from home location)
View our recruiting video: https://vimeo.com/323***********b7a16e
What you will gain:
Continued professional development in insurance fraud and surveillance investigations
Opportunities for advancement within PhotoFax
Performance-based pay and bonuses
Paid travel time
Support from an established nationwide investigative agency
What you need to apply:
Documented SIU or insurance investigations experience required
High school diploma required; Associates or Bachelors degree in Criminal Justice, Criminology, or Law Enforcement preferred
Valid drivers license
Clean driving record with minimal infractions
Must currently reside in the greater Miami area
Flexibility to work any day of the week, including weekends and holidays
Ability to work cases within a two-hour radius no overnight travel required
Job Type: Part-time
$29k-48k yearly est. 24d ago
Surveillance Investigator
Coventbridge Group 3.8
Coventbridge Group job in Orlando, FL
Now Building Our Florida Bench: Private Field Surveillance Investigator (Current and Future Openings)
Location: Orlando / Melbourne, FL (field-based) | Type: Independent/Field Investigations (Surveillance) | Schedule: Flexible
CoventBridge Group is growing-and we're hiring now while also building our pipeline for upcoming surveillance needs across Florida. This is a great opportunity for experienced investigators who are ready to take cases today, as well as professionals who want to get ahead by completing or finalizing Florida licensing, so they're positioned for the next wave of assignments. This evergreen posting is ideal if you're already licensed in Florida or you're actively pursuing licensing and want time to complete the process so you're ready when assignments open. This position requires a Class C License, or eligibility to obtain Class C License (2 years of investigative experience, or 1 year of investigative experience with a Criminal Justice degree.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
Responsibilities/ Requirements
What You'll Do
As a Private Field Surveillance Investigator, you'll conduct discreet, vehicle-based surveillance to help uncover insurance fraud and deliver trusted results to our clients. Your work will include:
Case prep & research using social media and database tools to build a smart plan before you roll
Mobile and stationary surveillance while maintaining professionalism, discretion, and safety
High-quality video documentation that captures key activity clearly and consistently
Daily reporting and evidence submission (upload video and written reports from your personal laptop)
Communication with your field leadership for support, guidance, and case direction
What We're Looking For
Active Florida Class C License (preferred)
or
in the process of completing and obtaining an active Florida Class C License
Prior surveillance / field investigations experience strongly preferred
Comfortable working independently, being on the road, and adapting quickly to changing case activity
Solid writing skills for clear, court-ready reporting
Tech-ready: able to upload video, submit reports, and follow digital case instructions reliably
Apply Today
If you're ready to take on surveillance assignments in Florida-now or soon-apply today. Qualified candidates may be contacted immediately for current opportunities and prioritized for upcoming needs.
Additional Responsibilities:
Duties and responsibilities include essential functions of positions assigned to this classification. Depending on assignment, the employee may perform a combination of some or all the following duties:
Conduct Fixed and Mobile Video Surveillance: Capture high-quality video footage of subjects to assist in case investigations.
Gather Evidence: Obtain videotaped documentation, photos, and audio recordings as part of thorough surveillance.
Background and Activity Checks: Perform courthouse research, background checks, and monitor subject activities to build robust case reports.
Investigative Reporting: Draft clear, concise, and detailed investigative reports summarizing findings and evidence.
Evidence Management: Upload all video, photographic, and audio evidence into the case management system in a timely and organized manner.
Drive Safely and Responsibly: Remain alert and practice safe driving while traveling to and from investigation sites.
Working Conditions:
Most surveillance cases start at 6:00AM. End time can vary depending on activity.
Weekends/holidays are common workdays as claimants are more likely to be active.
This is an independent role often requiring long hours alone in your vehicle, regardless of weather conditions.
Must remain alert with no external distractions, ready to use videography equipment to document subjects.
Benefits
Compensation & Perks That Work For You:
We believe great work deserves great rewards. Here's what you can expect when you join our team:
Competitive Pay:
Earn $25-$28 per hour, based on experience.
On-the-Road Support:
Monthly vehicle allowance
Company fuel card
Company-issued cell phone
Monthly internet stipend
Travel & report writing compensation
Fast, hassle-free expense reimbursements (minimal out-of-pocket costs)
Full Coverage Benefits:
Medical, dental, and vision insurance
Employer-paid life insurance, short-term & long-term disability
Future-Focused Perks:
Company-matching 401(k) to help you build for the future
Paid time off to recharge and reset
Company-paid investigator licensing fees
Career Growth:
Ongoing paid training and advancement opportunities to help you grow your skills and your career
The salary range for this role is $25-28 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
About Us:
CoventBridge Group is the global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients' needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.
CoventBridge Group is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge Group is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; ************; *******************************.
License #: A1000233
$25-28 hourly Auto-Apply 11d ago
Private Investigator / SIU (Part-Time)
Photofax 2.7
Miami, FL job
Private Investigator - Part-Time / Experienced (Miami, FL)
PhotoFax, Inc., a nationwide private detective agency, is currently hiring experienced surveillance investigators with SIU (Special Investigations Unit) experience to join our team in the Miami, FL region.
This position is designed for investigators with a background in insurance fraud or liability investigations who want flexible, part-time work with a professional agency. Candidates must have prior SIU and insurance claims investigation experience to be considered.
What your day will look like:
Monitoring, pursuing, and documenting individuals in a covert manner using your own vehicle
Conducting pre- and post-surveillance briefings with your case manager to review objectives and strategy
Preparing detailed reports on daily observations and findings
Uploading video and written documentation to the company database
Traveling within the surrounding Miami area (up to two hours from home location)
View our recruiting video: https://vimeo.com/323***********b7a16e
What you will gain:
Continued professional development in insurance fraud and surveillance investigations
Opportunities for advancement within PhotoFax
Performance-based pay and bonuses
Paid travel time
Support from an established nationwide investigative agency
What you need to apply:
Documented SIU or insurance investigations experience required
High school diploma required; Associate's or Bachelor's degree in Criminal Justice, Criminology, or Law Enforcement preferred
Valid driver's license
Clean driving record with minimal infractions
Must currently reside in the greater Miami area
Flexibility to work any day of the week, including weekends and holidays
Ability to work cases within a two-hour radius - no overnight travel required
Job Type: Part-time
Zippia gives an in-depth look into the details of CoventBridge Group, including salaries, political affiliations, employee data, and more, in order to inform job seekers about CoventBridge Group. The employee data is based on information from people who have self-reported their past or current employments at CoventBridge Group. The data on this page is also based on data sources collected from public and open data sources on the Internet and other locations, as well as proprietary data we licensed from other companies. Sources of data may include, but are not limited to, the BLS, company filings, estimates based on those filings, H1B filings, and other public and private datasets. While we have made attempts to ensure that the information displayed are correct, Zippia is not responsible for any errors or omissions or for the results obtained from the use of this information. None of the information on this page has been provided or approved by CoventBridge Group. The data presented on this page does not represent the view of CoventBridge Group and its employees or that of Zippia.
CoventBridge Group may also be known as or be related to CoventBridge Group, CoventBridge Group Ltd, CoventBridge Group Ltd., Coventbridge (usa) Inc. and Coventbridge Group.