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  • Criminal Investigator (Special Agent) (Reemployed Annuitant)

    Department of Homeland Security 4.5company rating

    Investigator job in Los Angeles, CA

    ICE is hiring for law enforcement jobs that have an exciting opportunity! Once onboarded and if in the DC local area, you may be assigned for up to one year to support the D.C. Safe and Beautiful Task Force. The law enforcement component of the D.C. Task Force is a partnership of over 20 federal and local agencies working together to make D.C. the safest city in America. Once the assignment ends, you'll transition back to support ICE. Visit the D.C. Task Force page for more information. Summary ICE is hiring for law enforcement jobs that have an exciting opportunity! Once onboarded and if in the DC local area, you may be assigned for up to one year to support the D.C. Safe and Beautiful Task Force. The law enforcement component of the D.C. Task Force is a partnership of over 20 federal and local agencies working together to make D.C. the safest city in America. Once the assignment ends, you'll transition back to support ICE. Visit the D.C. Task Force page for more information. Overview Help Accepting applications Open & closing dates 11/06/2025 to 12/31/2025 Salary $105,383 to - $171,268 per year Pay scale & grade GS 13 Locations Many vacancies in the following locations: Phoenix, AZ Los Angeles, CA San Diego, CA San Francisco, CA Show morefewer locations (25) Denver, CO Washington, DC Miami, FL Tampa, FL Atlanta, GA Honolulu, HI Chicago, IL Kansas City, KS New Orleans, LA Boston, MA Baltimore, MD Detroit, MI Saint Paul, MN Charlotte, NC Newark, NJ Buffalo, NY New York, NY Philadelphia, PA San Juan, PR Nashville, TN Dallas, TX El Paso, TX Houston, TX San Antonio, TX Seattle, WA Remote job No Telework eligible No Travel Required Occasional travel - You may be expected to travel for this position. Relocation expenses reimbursed No Appointment type Term - 1 Year Work schedule Full-time Service Competitive Promotion potential 13 Job family (Series) * 1811 Criminal Investigation Supervisory status No Security clearance Top Secret Drug test Yes Position sensitivity and risk Critical-Sensitive (CS)/High Risk Trust determination process * Suitability/Fitness Financial disclosure No Bargaining unit status No Announcement number HSI-12830647-RHA Control number 849707200 This job is open to Help Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Special authorities Individuals eligible under a special authority not listed in another hiring path. Clarification from the agency Retirees under Federal Employee Retirement System (FERS) or Civil Service Retirement System (CSRS) who are eligible for re-employment as a Federal Annuitant AND previously worked as an 1811 for any Federal Government Agency and Federal CTAP, ICTAP and RPL eligibles. Retired applicants must be retired on or before the opening date of this announcement. Duties Help As a Criminal Investigator (Special Agent), you will perform duties such as: * Serve as a Special Agent for interagency, multi-jurisdictional, international, and/or inter-organizational inquiries and investigations; * Conduct investigations of unusual difficulty and responsibility associated with trade, travel, finance, and immigration for combatting illicit activities associated with individuals, businesses, employers, criminal organizations or criminal conspiracies, and cyber systems and networks; * Utilize a combined methodology of intelligence, investigative techniques, and legal authorities to conduct investigations and associated activities; * Apply knowledge of the trends, laws, and investigative case development, independently or in coordination with other law enforcement officers (LEOs) or agencies to accomplish work; * Prepare written documentation utilizing expert knowledge in support of investigations; * May lead teams of special agents and other law enforcement officers; make assignments and provide guidance and coordination to team members; and * May instruct special agents in the appropriate use of Firearms and application of Defensive Tactics. Salary: The salary range indicated in this announcement reflects the lowest and highest potential salaries for this position. The actual salary range will be based on the applicable locality pay for the selected duty location. General Schedule locality pay tables may be found under Salaries & Wages. Are you ready to return to mission? Resume your impactful and thrilling career as a Criminal Investigator with HSI at ICE! Rejoin an elite team dedicated to defending the U.S. by tackling complex criminal threats and securing our nation's safety. This role offers up to $50,000 in signing and retention bonuses, a Dual Compensation Waiver, and a streamlined onboarding process. If you're ready to serve with pride once again, apply and reclaim your vital role in preserving homeland security! You have the opportunity to identify one location preference Special Agent in Charge (SAC) office area of responsibility. Note that multiple duty locations fall within the area of responsibility (AOR) of each SAC office. Please view the duty locations within each SAC AOR here. Your location preferences are NOT guaranteed. The duty locations offered will be based on the needs of the agency. If you decline the duty locations offered during the official job offer, you will be removed from further consideration. Note: Selectees for the Glynco, GA, Huntsville AL and Charleston, SC locations may be assigned as Firearms and Defensive Tactics instructors. Retired applicants must be retired on or before the opening date of this announcement. This announcement may be used to fill additional vacancies based on the needs of the Agency. View Common Definitions of terms found in this announcement. Organizational Location: These positions are located in the Department of Homeland Security, U.S. Immigration and Customs Enforcement, Homeland Security Investigations in multiple locations. This is a term position not-to-exceed 1 year (may be extended based on the needs of the Agency). Recruitment and retention incentives available to eligible candidates require a service agreement. Requirements Help Conditions of employment * You must be a U.S. citizen to apply for this position. * You must successfully pass a background investigation. * You must successfully pass a drug screen. * Males born after 12/31/59 must certify registration with Selective Service. * Requirements by Closing Date: Unless otherwise noted, you must meet all requirements by the closing date of the announcement. * Time in Grade: Time in grade restrictions must be met by the closing date of this announcement. Applicants must have at least 52 weeks of service equivalent to the next lower grade level in the normal line of progression for the position to be filled * Motor Vehicle Operation: You must possess a valid automobile driver's license at the time of appointment. * This position requires the selectee to carry a firearm. Any person who has been convicted of a misdemeanor crime of domestic violence cannot lawfully possess a firearm or ammunition (Title 18, U.S.C. Section 022 (g)(9)). * Convictions of misdemeanor crime of domestic violence are disqualifying. * Work Conditions: Job requires physical strength and stamina due to long periods of surveillance, restraining suspects, and carrying heavy equipment. Environment includes work indoors/outdoors in a potentially dangerous and stressful situations. * Travel: You will be required to travel frequently and on short notice. * Medical Requirements: You may be required to pass a pre-employment medical examination. * You will be required to live within 50 miles of your duty station. * You may be required to testify at court. Law enforcement officers and agents must be able to testify without concern of impeachment. Qualifications Dual Compensation Off-Set Waiver for Criminal Investigators (Special Agents) Approved for Rehires: This announcement is being used to recruit CSRS and FERS annuitants on a limited basis with a waiver of salary offset (if a dual compensation waiver is requested) under certain specified circumstances not to exceed 6/30/2028 excluding annuitants with early voluntary and buyout retirements. Annuitants who are reemployed with a salary offset (dual compensation) waiver are eligible for: * Full annuity and full Federal salary * Annual and sick leave (not applicable for an intermittent work schedule) * Full-time work schedules * Receive overtime (on a full schedule). Overtime hours are counted towards maximum hour limitations * Law Enforcement Availability Pay (LEAP) - additional compensation of 25% of the base salary added to locality pay * New hires under this authority will be offered a non-status, term appointment in the competitive service not-to-exceed 1 year (may be extended based on the needs of the Agency). Annuitants who are reemployed with a salary offset (dual compensation) waiver are NOT eligible for: * Additional retirement coverage (other than Social Security coverage). * TSP Contributions. Reemployed annuitants may only receive one appointment per job series. To be considered qualified for this position you must meet the following qualification requirements: Please limit your resume to 2 pages. If more than 2 pages are submitted, only the first 2 pages will be reviewed to determine your eligibility/qualifications. You qualify for the GS-13 grade level if you possess one (1) year of specialized experience at the GS-12 grade level or equivalent performing the following duties/duties such as: * Conducting a broad range of investigations of a very high order of difficulty and responsibility, and exercising specialized expertise in programmatic areas such as narcotics, money laundering, financial crimes, human trafficking, fraud, international trade, network intrusion response, counterintelligence, counterterrorism, counterproliferation or general criminal investigations; * Reviewing files and performing complex federal, state, and local law enforcement-related database queries, using law enforcement sensitive and classified databases; * Maintaining, developing, and enhancing inter-agency partnerships, and connections with other governmental and private sector entities; * Planning and implementing strategies for the collection and analysis of information to support long-term criminal investigations; * Conducting interviews and interrogations using advanced techniques with a wide variety of individuals (e.g., suspects, witnesses, sources, and/or victims) to gather information; * Preparing reports, using expert knowledge, in support of general criminal actions; * Leading immigration-related law enforcement actions or investigations (e.g., worksite cases, visa overstays, immigration fraud investigations, administrative immigration enforcement). Qualification requirements must be met by the closing date of this announcement. Qualification claims will be subject to verification. National Service Experience (i.e., volunteer experience): Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Current or Former Political Appointees: The Office of Personnel Management (OPM) must authorize employment offers made to current or former political appointees. If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, Non-career SES or Presidential Appointee employee in the Executive Branch, you must disclose this information to the Human Resources Office. Education Medical Requirement: You may be required to pass a pre-employment medical examination. Firearms Requirement: You will be required to carry a firearm while performing duties of this position. Maintaining firearm proficiency is also mandatory. You must satisfactorily complete (or have previously completed) the firearms component of the Criminal Investigation Training Program at Glynco, Georgia. Any person who has been convicted of a misdemeanor crime of domestic violence cannot lawfully possess a firearm or ammunition. Candidates under consideration will be required to certify whether they have ever been convicted of such an offense. False or fraudulent information provided by candidates is criminally punishable by fine or imprisonment. Work Conditions: This job requires physical strength and stamina to perform such activities as conducting long periods of surveillance, pursuing and restraining suspects, and carrying heavy equipment to be uses in investigative efforts. These activities require considerable physical exertion, such as running, stooping, bending, climbing, lifting and carrying heavy objects. The environment involves work indoors and outdoors in a variety of potentially dangerous and stressful situations, as well as exposure to physical attack, including the use of lethal weapons. Additional information To support operational needs, applicant lists will be generated every two weeks or earlier and offers of employment may be extended prior to the close of the announcement. These are non-bargaining unit positions. This position is at the full performance level. E-Verify: DHS uses E-Verify, an Internet-based system, to confirm the eligibility of all newly hired employees to work in the United States. Learn more about E-Verify, including your rights and responsibilities. Suitability: If you receive a conditional offer of employment for this position, you will be required to complete an Optional Form 306, Declaration for Federal Employment, and to sign and certify the accuracy of all information in your application, prior to entry on duty. False statements on any part of the application may result in withdrawal of offer of employment, dismissal after beginning work, fine, or imprisonment. Background Investigation: To ensure the accomplishment of our mission, DHS requires every employee to be reliable and trustworthy. To meet these standards, all selected applicants must undergo and successfully obtain and maintain a background investigation for Top Secret as a condition of placement into this position. This may include a credit check, a review of financial issues such as delinquency in the payment of debts, child support and/or tax obligations, as well as certain criminal offenses and illegal use or possession of drugs. Polygraph: ICE has designated this position for polygraph testing, which you may be required to complete. If referred for polygraph testing, you may be required to travel to a testing location. Expand Hide additional information Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Benefits Help A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new window Learn more about federal benefits. Law Enforcement Availability Pay (LEAP): This position may require substantial amounts of irregular or occasional overtime. You will be required to work on an unscheduled basis in excess of the 40-hour workweek. You must be readily available to perform this unscheduled overtime on a continual basis. Upon entering on duty, LEAP will be paid to reemployed annuitants. Benefits: DHS offers competitive salaries and an attractive benefits package, including: health, dental, vision, life, and long-term care insurance; retirement plan; Thrift Savings Plan [similar to a 401(k)]; Flexible Spending Account; Employee Assistance Program; personal leave days; and paid federal holidays. Other benefits may include: flexible work schedules; telework; tuition reimbursement; transportation subsidies; uniform allowance; health and wellness programs; and fitness centers. DHS is committed to employee development and offers a variety of employee training and developmental opportunities. For more information, go to the DHS Careers website and select "Benefits. Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered. How you will be evaluated You will be evaluated for this job based on how well you meet the qualifications above. We will review your resume and supporting documentation to ensure you meet the minimum qualification requirements. If you meet the minimum qualifications, your experience, education, and training will be rated using an Assessment Questionnaire that is based on the following competencies or knowledge, skills, and abilities needed to perform this job: * Conscientiousness * Decision Making and Judgment * Interpersonal Skills * Manages Human Resources * Managing and Organizing Information * Teamwork Based on your responses, you will receive a score from the Assessment Questionnaire between 70 and 100. If you are best qualified, you may be referred to the hiring manager for consideration and may be called for an interview. Interviews may be required for this position. Failure to complete the interview may result in removal from further consideration. Due weight will be given to performance appraisals and incentive awards in merit promotion selection decisions in accordance with 5 CFR 335.103(b)(3). Pursuant to Executive Order 12564, and the DHS Drug-Free Workplace Plan, ICE is committed to maintaining a drug-free workplace and, therefore, personnel in safety- or security-sensitive positions (testing designated positions) are subject to random drug testing. Moreover, other drug testing of employees (e.g., reasonable suspicion drug test) may be conducted in order to ensure a safe and healthy work environment. All applicants tentatively selected for employment at ICE are subject to pre-employment drug testing and a final offer of employment is contingent upon a negative drug test result. Benefits Help A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new window Learn more about federal benefits. Law Enforcement Availability Pay (LEAP): This position may require substantial amounts of irregular or occasional overtime. You will be required to work on an unscheduled basis in excess of the 40-hour workweek. You must be readily available to perform this unscheduled overtime on a continual basis. Upon entering on duty, LEAP will be paid to reemployed annuitants. Benefits: DHS offers competitive salaries and an attractive benefits package, including: health, dental, vision, life, and long-term care insurance; retirement plan; Thrift Savings Plan [similar to a 401(k)]; Flexible Spending Account; Employee Assistance Program; personal leave days; and paid federal holidays. Other benefits may include: flexible work schedules; telework; tuition reimbursement; transportation subsidies; uniform allowance; health and wellness programs; and fitness centers. DHS is committed to employee development and offers a variety of employee training and developmental opportunities. For more information, go to the DHS Careers website and select "Benefits. Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered. Required documents Required Documents Help * Resume showing relevant experience, education and training. Work experience should include: job title, duties, employer's name, employer's telephone number, employer's address, starting and ending dates (MM/YY), hours worked per week, and indicate whether or not we may contact your current supervisor. Please limit your resume to 2 pages. If more than 2 pages are submitted, only the first 2 pages will be reviewed to determine your eligibility/qualifications (for more information, see the Frequently Asked Questions about the two-Page Resume Limit). * Are you a current or former political Schedule A, Schedule C, Non-career SES or Presidential Appointee employee? Submit a copy of your applicable SF-50, along with a statement that provides the following information regarding your most recent political appointment: Position title, type of appointment (Schedule A, Schedule C, Non-career SES, or Presidential Appointee), agency and beginning and ending dates of appointment. * Please provide a copy of your retirement SF-50 (Notification of Personnel Action). Retired applicants must be retired on or before the opening date of this announcement. * You may be asked to provide a copy of your recent performance appraisal and/or incentive awards. If you are relying on your education to meet qualification requirements: Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
    $53k-72k yearly est. 27d ago
  • Social Media Investigator

    Frasco Inc. 4.1company rating

    Investigator job in Irvine, CA

    Job Title: Research Investigator Job Type: Full-Time, Billable Hours, Non-exempt Compensation: $17 - $22/hour, paid weekly Reports To: Regional Manager 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 The Social Media Investigator performs desktop research across platforms, requiring strong analysis, covert surveillance skills, quality control, factual report writing, with clear and concise communication skills. Candidates with knowledge and/or certifications of OSNIT and HUMINT are encouraged to apply. Essential job functions include, but are not limited to: Background checks Social media searches Public record searches Preparing detailed investigation reports Adhering to strict due dates/timelines Attending and testifying at hearings as needed About Us: Frasco is a leading provider of investigative services for our clients in the insurance industry. We are committed to delivering accurate, high-quality investigation services to meet our clients' expectations. Requirements: Social Media Investigator candidates must have: Excellent verbal and written English communication skills Ability to communicate ideas effectively and professionally Ability to work under pressure and meet deadlines Ability to work both independently and as a team player Attention and commitment to accuracy and detail Strong computer skills with knowledge of Microsoft Office Ability to multi-task Ability to model behaviors that reflect Frasco's core values If required by your residential state, a private investigator's license Preferred Qualifications/Experience: Understanding of available public records & how to obtain information Knowledge of social media platforms Experience with OSINT tools and techniques SOCMINT and GEOINT knowledge is a plus Insurance industry knowledge Bi-lingual in Spanish and English (Fluent verbal and written Spanish a plus) Associate or bachelor's degree in criminal justice or related field Start your career with a leader in the investigations industry that is financially stable, experiencing considerable growth, and whose history spans over 60 years! Ready to make a difference? Apply now!All replies are confidential EqualEmployment Opportunity Employer PM18 Compensation details: 17-22 Hourly Wage PId485263e302e-26***********4
    $17-22 hourly Easy Apply 2d ago
  • Private investigator

    USA Express Legal & Investigative Service Inc.

    Investigator job in Santa Ana, CA

    Job DescriptionLooking for private investigator or anyone is in training to become an investigator to handle field assignments for personal injury cases. Training will be provided. Immediate opening. We pay hourly rate plus IRS applicable mileage.
    $53k-96k yearly est. 25d ago
  • Fraud Investigator

    ADP 4.7company rating

    Investigator job in San Dimas, CA

    ADP is hiring a **Senior Fraud, Client Svc & Prod Supt Consultant** - Wisely Card Product in our Employee Financial Solutions organization. The Senior Fraud Analyst serves as a technical expert and investigative resource for the Wisely Card product. This role is responsible for in-depth analysis of complex fraud cases, advanced data analysis and reporting, and providing consultative support to internal teams and external partners. The ideal candidate will leverage strong Excel skills and investigative expertise to resolve issues, improve processes, and support operational excellence. Ready to #MakeYourMark? **Apply now!** **WHAT YOU'LL DO:** Responsibilities + Conduct in-depth investigations of complex fraud cases, using advanced analytical and investigative techniques + Utilize strong Excel skills for data analysis, reporting, and metrics to identify trends and support business decisions + Assist with developing, implementing, and optimizing fraud rules (including Feedzai) in collaboration with vendors and internal stakeholders + Provide second-tier support and subject matter expertise to internal teams and external partners + Develop and maintain reports, dashboards, and presentations to communicate findings and recommendations + Collaborate with vendors and internal stakeholders to optimize fraud prevention strategies and resolve issues + Identify process gaps and propose solutions to enhance fraud detection and mitigation + Support compliance initiatives, audits, and regulatory reporting as required + Communicate effectively with senior leaders to provide updates and recommendations + Mentor colleagues and share best practices in fraud investigation and analytics + Act as a resource for project-oriented assignments and cross-functional initiatives **TO SUCCEED IN THIS ROLE:** Requirements + **This role is located in our San Dimas, CA office. We support a hybrid working arrangement (3 days in the office minimum with 2 days at home).** + 5+ years of experience in fraud investigation, risk management, or compliance + Strong Excel skills and technical proficiency in data analysis and reporting + Demonstrated expertise in investigative techniques and problem-solving + Experience supporting internal and external stakeholders in a complex business environment + Experience with fraud monitoring, fraud detection and interpretation. + Experience with fraud rules development, and optimization, including Feedzai or similar tools. + Excellent written and verbal communication skills, including the ability to communicate with Senior Leadership and cross-functional partners + Ability to work independently and manage multiple priorities + Proven ability to lead projects and drive operational changes + Visionary mindset with the ability to anticipate issues, and implement system changes **A college degree is great but not required. What's more important is having the skills to do the job. Other acceptable experiences could include:** + Experience noted above, OR + Military Experience. We recognize and appreciate the unique talents and experiences Veterans bring to the table. We value the discipline, commitment, and problem-solving abilities you developed and are excited to provide an environment where you can continue to make a meaningful impact **Bonus points for these:** _Preferred Qualifications_ + Advanced degree + Professional Certifications: Certified Fraud Examiner (CFE), Certified Anti-Money Laundering Specialist (CAMS). + Experience with the following tools: Feedzai or similar, Threat Metrix, Visa, LexisNexis + Background in payroll, implementation, and/or contact center operations is a plus. + Excellent communication skills + Fast learner + Ability to influence + Analytical Base salary offers for this position may vary based on factors such as location, skills, and relevant experience. Some positions may include additional compensation in the form of bonus, equity or commissions. We offer the following benefits: Medical, Dental, Vision, Life Insurance, Matched Retirement Savings, Wellness Program, Short-and Long-Term Disability, Charitable Contribution Match, Holidays, Personal Days & Vacation, Paid Volunteer Time Off, and more. The compensation for this role is USD $59,100.00 - USD $120,200.00 / Year* *Actual compensation will not be less than the applicable minimum wage or minimum exempt salary requirement under federal, state and local laws. **A little about ADP:** We are a comprehensive global provider of cloud-based human capital management (HCM) solutions that unite HR, payroll, talent, time, tax and benefits administration and a leader in business outsourcing services, analytics, and compliance expertise. We believe our people make all the difference in cultivating a down-to-earth culture that embraces our core values, welcomes ideas, encourages innovation, and values belonging. We've received recognition for our work by many esteemed organizations, learn more at ADP Awards and Recognition (********************************************************** . **Diversity, Equity, Inclusion & Equal Employment Opportunity at ADP:** ADP is committed to an inclusive, diverse and equitable workplace, and is further committed to providing equal employment opportunities regardless of any protected characteristic including: race, color, genetic information, creed, national origin, religion, sex, affectional or sexual orientation, gender identity or expression, lawful alien status, ancestry, age, marital status, protected veteran status or disability. Hiring decisions are based upon ADP's operating needs, and applicant merit including, but not limited to, qualifications, experience, ability, availability, cooperation, and job performance. **Ethics at ADP:** ADP has a long, proud history of conducting business with the highest ethical standards and full compliance with all applicable laws. We also expect our people to uphold our values with the highest level of integrity and behave in a manner that fosters an honest and respectful workplace. Click ********************************* to learn more about ADP's culture and our full set of values.
    $59.1k-120.2k yearly 10d ago
  • Los Angeles, CA Private Investigator Trainee

    Lemieux & Associates LLC

    Investigator job in Los Angeles, CA

    Job Description Job Opportunity: Private Investigator Trainee Seeking Veterans Ready for a New Challenge Join Our Team as a Private Investigator Trainee Are you recently separated from the military and searching for your next mission? We are looking for dedicated individuals who are ready to transition into an exciting new career as a Private Investigator Trainee. Lemieux & Associates, a national leader in the investigative industry, is seeking Military Veterans looking to be trained as a Private Investigator in the Los Angeles, CA or surrounding area. This is a full-time position for the right individual. No Experience Necessary - We Provide Comprehensive Training Who We're Looking For: Motivated, disciplined individuals who have recently left military service. Experience: None required. If you have the drive and a strong work ethic, we will train you! Training: Full, hands-on instruction provided for the right candidate. Learn investigation techniques, surveillance, and more from industry experts. Qualities: Integrity, attention to detail, and a desire to help others. Position Summary A majority of the work activity involves field surveillance requiring the investigator to obtain high quality videotape documentation of claimants who have filed workers compensation and liability/personal injury claims. Investigators are also responsible for submitting accurate and timely reports regarding the results of their investigations. In addition, investigators conduct background investigations, neighborhood canvasses, activity checks, and locates. The Field Investigator performs their duties using the highest legal and ethical investigative standards while efficiently utilizing time and resources to provide outstanding investigative services. Qualifications Bi-lingual is a plus Ability and willingness to travel as necessary Flexibility to work varied/irregular hours and days Strong computer and Internet skills Possess a valid state-issued driver's license Possess a reliable vehicle, digital camera and computer with Windows Operating System, Microsoft Word and Internet connection Benefits Competitive pay Career growth opportunities Supportive team environment We offer Medical, Dental, 401K, Paid Vacation and Paid Holidays How to Apply If you are ready to put your skills to work in a new way and want to learn from the best, we want to hear from you! Please submit your resume and a brief cover letter explaining why you are interested in becoming a Private Investigator. Start Your Next Adventure Today!
    $54k-99k yearly est. 27d ago
  • Fraud Investigative Lead Supervisor

    Open 3.9company rating

    Investigator job in Los Angeles, CA

    Our roster has an opening with your name on it This role is responsible for leading and conducting comprehensive, complex investigations related to regulator concerns related to deposit fraud, play integrity, abuse, account takeovers, organized fraud, and other fraud specific investigations. This position will be a part of internal quality assurance testing as it relates to fraud processes along with preparing and presenting findings. This role is required to stay current on fraud trends and emerging threats and present case studies to the broader team on a recurring basis. As a Fraud Investigative Lead Supervisor, you will be contributing to state-specific reporting and regulatory-related fraud reviews. In addition to completing and leading investigations, this role will be responsible for overseeing direct reports, and managing tasks such as coordinating job rotations, providing regular and consistent feedback to direct reports, reporting significant findings and activity updates to the Fraud investigative Manager, goal coaching, and other supervisory tasks. This role may assist in designing, documenting, implementing, and monitoring of new procedures/services. Candidates for this role must pass the required licensing as mandated by various state gaming and racing regulatory bodies. Failure to be licensed or retain licensure will result in termination of employment. This position reports to the Fraud Investigative Manager. In addition to the specific responsibilities outlined above, employees may be required to perform other such duties as assigned by the Company. This ensures operational flexibility and allows the Company to meet evolving business needs. THE GAME PLAN Everyone on our team has a part to play Train and mentor Fraud Investigators and Fraud Prevention Analysts within our department Participate in quality assurance testing related to fraud prevention efforts Prepare investigation reports, summaries, and present findings Investigate and research allegations of fraud or abuse of system controls and communicate root cause findings Lead applicable state-specific regulatory fraud form reporting and regulator investigations Research, evaluate, and analyze information and intelligence to determine risk Aid in developing fraud mitigation strategies OSINT collection and analysis Collaborate with other departments within our organization, such as Security, Risk, Compliance, and other related teams Analyze past and current fraud trends and suspicious behavior tracking Continually learn and adapt to changing fraud trends and behavior Other tasks and projects as assigned by the leadership team THE STATS What we're looking for in our next teammate 3+ years of fraud experience in daily fantasy sports, online gaming or related industries 1+ years of leadership experience preferred Proficiency with SQL required Experience with digital payments and understanding of e-Commerce platforms Cybersecurity experience a plus Experience interacting with regulators and compliance a plus Prior experience using open-source intelligence Strong verbal and written communication skills Bachelor's degree in related field preferred Demonstrated aptitude for process execution, including identification of areas for improvement In-depth knowledge and understanding of common fraud trends and emerging threats Advanced knowledge of common fraud prevention strategies and systems Intermediate understanding of Check, ACH, Wire, Debit/Credit card, PayPal and other payment channel operating rules Effective communication, organizational, problem-solving, and analytical skills Passion for sports and/or gaming industry a plus Licensure: Must be able to pass required licensing as mandated by various state racing and gaming regulatory bodies ABOUT FANDUEL FanDuel Group is the premier mobile gaming company in the United States and Canada. FanDuel Group consists of a portfolio of leading brands across mobile wagering including: America's #1 Sportsbook, FanDuel Sportsbook; its leading iGaming platform, FanDuel Casino; the industry's unquestioned leader in horse racing and advance-deposit wagering, FanDuel Racing; and its daily fantasy sports product. In addition, FanDuel Group operates FanDuel TV, its broadly distributed linear cable television network and FanDuel TV+, its leading direct-to-consumer OTT platform. FanDuel Group has a presence across all 50 states, Canada, and Puerto Rico. The company is based in New York with US offices in Los Angeles, Atlanta, and Jersey City, as well as global offices in Canada and Scotland. The company's affiliates have offices worldwide, including in Ireland, Portugal, Romania, and Australia. FanDuel Group is a subsidiary of Flutter Entertainment, the world's largest sports betting and gaming operator with a portfolio of globally recognized brands and traded on the New York Stock Exchange (NYSE: FLUT). PLAYER BENEFITS We treat our team right We offer amazing benefits above and beyond the basics. We have an array of health plans to choose from (some as low as $0 per paycheck) that include programs for fertility and family planning, mental health support, and fitness benefits. We offer generous paid time off (PTO & sick leave), annual bonus and long-term incentive opportunities (based on performance), 401k with up to a 5% match, commuter benefits, pet insurance, and more - check out all our benefits here: FanDuel Total Rewards. *Benefits differ across location, role, and level. FanDuel is an equal opportunities employer and we believe, as one of our principles states, “We are One Team!”. As such, we are committed to equal employment opportunity regardless of race, color, ethnicity, ancestry, religion, creed, sex, national origin, sexual orientation, age, citizenship status, marital status, disability, gender identity, gender expression, veteran status, or any other characteristic protected by state, local or federal law. We believe FanDuel is strongest and best able to compete if all employees feel valued, respected, and included. FanDuel is committed to providing reasonable accommodations for qualified individuals with disabilities. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please email ********************. The applicable salary range for this position is $78,000 - $97,000 USD, which is dependent on a variety of factors including relevant experience, location, business needs and market demand. This role may offer the following benefits: medical, vision, and dental insurance; life insurance; disability insurance; a 401(k) matching program; among other employee benefits. This role may also be eligible for short-term or long-term incentive compensation, including, but not limited to, cash bonuses and stock program participation. This role includes paid personal time off and 14 paid company holidays. FanDuel offers paid sick time in accordance with all applicable state and federal laws. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. #LI-Hybrid
    $78k-97k yearly Auto-Apply 1d ago
  • Mail Fraud Investigative Analyst

    KACE

    Investigator job in Los Angeles, CA

    Title: Mail Fraud Investigative Support Analyst Security Clearance: Moderate Background Investigation (MBI) Salary: Approximately $105,000 / annual Schedule: Due to the nature of law enforcement work and operation, position may require occasional support outside of core working hours, as well as intermittent weekend support, mission dependent. Travel: Travel may be required. About KACE: When you make the decision to join KACE, you are choosing to work alongside talented professionals that have one thing in common; the passion to make a difference! KACE employees bring their diverse talents and experiences to work on critical projects that help shape the nation's safety, security, and quality of life. The desire to have a career that is purposeful and forward thinking is woven into every KACE employee…it's The KACE Way. KACE employees are; purpose driven, forward focused, open-minded, trustworthy and invested. The KACE Way is our commitment to our employees, to our customers, and to our communities. Join KACE and make a difference! Job Summary: The Investigative Support Analyst provides task-specific investigative support to designated criminal and civil investigations in the Inspection Service field division offices. Essential Functions and Responsibilities: Analysis - Review and analyze business records; trace proceeds of illegal activity in order to prepare cash flow analysis; perform personal wealth analysis and related financial transactions; present findings in reports and presentations in non-technical terminology to various audiences. Research - Data-mine Postal records and other databases to indentify fraudulent activity; prepare reports documenting analytical results; disseminate research results to appropriate contact(s) in a timely manner. Planning and Preparation - Complete assigned tasks to ensure completion within required timeframes to support the criminal or civil investigation, as appropriate; assist Postal Inspectors with developing intelligence for criminal investigations; prepare initial investigative research; compile basic background information to include, but not limited to, researching all pertinent records and other data. Reporting Responsibilities - Responsible for documenting and reporting analytical results, creating graphic displays and reports that present clear and concise representations of the information analyzed; and disseminating data as required by the assigned task(s). Minimum Qualifications & Skills: Bachelor's Degree from an accredited college or university AND a minimum of ten years investigative experience planning, conducting and participating in complex financial investigations with a minimum of five years specialized experience in areas such as mail fraud, money laundering, organized crime, forfeiture or similar area of criminal activity. Demonstrated knowledge of federal statutes and the federal rules of criminal and civil procedure; Extensive experience in communicating orally and in writing to clearly explain steps and results in research and analysis using multiple mediums such as charts and reports; Extensive experience in conducting research using the Internet and other commercial/public databases; Demonstrated significant ability to analyze investigative results and present sound recommendations for additional investigative action; Extensive experience developing civil and/or criminal cases for presentation to the appropriate prosecution authority; Extensive experience identifying the appropriate analytical techniques and methods during an investigation; Demonstrated extensive ability to prepare complex criminal and/or civil investigations; Demonstrated extensive experience showing the ability to work independently; Demonstrated significant ability to prepare a final work product; Prior experience investigating complex financial investigations; Prior experience developing forfeiture in an investigation; Proficiency with the Microsoft suite of products, Adobe Acrobat Pro, i2, financial analytical software; Experience researching social media activity; Knowledge of FinCEN and Anti Money Laundering processes. Clearance: Applicants selected may be subject to a government background investigation and may be required to meet the following conditions of employment. Security Requirements/Background Investigation Requirements: Must be a U.S Citizen or Legal Permanent Resident. Favorable credit check for all cleared positions Successfully passing a background investigation including drug screening. Physical Requirements/Working Conditions: Standing/Walking/Mobility: Must have mobility to attend meetings with other managers and employees. Standing for prolonged and extended periods of time. Climbing/Stooping/Kneeling: 0% - 10% of the time. Lifting/Pulling/Pushing: 0% - 10% of the time. Fingering/Grasping/Feeling: Must be able to write, type and use a telephone system 100% of the time. Sitting: Sitting for prolonged and extended periods of time. This reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. Management may revise duties as necessary without updating this job description. For more information about the company please visit our website at ******************* KACE is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, disability or any other federal, state or local protected class.KACE complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to **************************.
    $105k yearly Auto-Apply 47d ago
  • Fraud Investigative Lead Supervisor

    Flutter Entertainment PLC

    Investigator job in Los Angeles, CA

    :" Our roster has an opening with your name on it This role is responsible for leading and conducting comprehensive, complex investigations related to regulator concerns related to deposit fraud, play integrity, abuse, account takeovers, organized fraud, and other fraud specific investigations. This position will be a part of internal quality assurance testing as it relates to fraud processes along with preparing and presenting findings. This role is required to stay current on fraud trends and emerging threats and present case studies to the broader team on a recurring basis. As a Fraud Investigative Lead Supervisor, you will be contributing to state-specific reporting and regulatory-related fraud reviews. In addition to completing and leading investigations, this role will be responsible for overseeing direct reports, and managing tasks such as coordinating job rotations, providing regular and consistent feedback to direct reports, reporting significant findings and activity updates to the Fraud investigative Manager, goal coaching, and other supervisory tasks. This role may assist in designing, documenting, implementing, and monitoring of new procedures/services. Candidates for this role must pass the required licensing as mandated by various state gaming and racing regulatory bodies. Failure to be licensed or retain licensure will result in termination of employment. This position reports to the Fraud Investigative Manager. In addition to the specific responsibilities outlined above, employees may be required to perform other such duties as assigned by the Company. This ensures operational flexibility and allows the Company to meet evolving business needs. THE GAME PLAN Everyone on our team has a part to play * Train and mentor Fraud Investigators and Fraud Prevention Analysts within our department * Participate in quality assurance testing related to fraud prevention efforts * Prepare investigation reports, summaries, and present findings * Investigate and research allegations of fraud or abuse of system controls and communicate root cause findings * Lead applicable state-specific regulatory fraud form reporting and regulator investigations * Research, evaluate, and analyze information and intelligence to determine risk * Aid in developing fraud mitigation strategies * OSINT collection and analysis * Collaborate with other departments within our organization, such as Security, Risk, Compliance, and other related teams * Analyze past and current fraud trends and suspicious behavior tracking * Continually learn and adapt to changing fraud trends and behavior * Other tasks and projects as assigned by the leadership team THE STATS What we're looking for in our next teammate * 3+ years of fraud experience in daily fantasy sports, online gaming or related industries * 1+ years of leadership experience preferred * Proficiency with SQL required * Experience with digital payments and understanding of e-Commerce platforms * Cybersecurity experience a plus * Experience interacting with regulators and compliance a plus * Prior experience using open-source intelligence * Strong verbal and written communication skills * Bachelor's degree in related field preferred * Demonstrated aptitude for process execution, including identification of areas for improvement * In-depth knowledge and understanding of common fraud trends and emerging threats * Advanced knowledge of common fraud prevention strategies and systems * Intermediate understanding of Check, ACH, Wire, Debit/Credit card, PayPal and other payment channel operating rules * Effective communication, organizational, problem-solving, and analytical skills * Passion for sports and/or gaming industry a plus * Licensure: Must be able to pass required licensing as mandated by various state racing and gaming regulatory bodies ABOUT FANDUEL FanDuel Group is the premier mobile gaming company in the United States and Canada. FanDuel Group consists of a portfolio of leading brands across mobile wagering including: America's #1 Sportsbook, FanDuel Sportsbook; its leading iGaming platform, FanDuel Casino; the industry's unquestioned leader in horse racing and advance-deposit wagering, FanDuel Racing; and its daily fantasy sports product. In addition, FanDuel Group operates FanDuel TV, its broadly distributed linear cable television network and FanDuel TV+, its leading direct-to-consumer OTT platform. FanDuel Group has a presence across all 50 states, Canada, and Puerto Rico. The company is based in New York with US offices in Los Angeles, Atlanta, and Jersey City, as well as global offices in Canada and Scotland. The company's affiliates have offices worldwide, including in Ireland, Portugal, Romania, and Australia. FanDuel Group is a subsidiary of Flutter Entertainment, the world's largest sports betting and gaming operator with a portfolio of globally recognized brands and traded on the New York Stock Exchange (NYSE: FLUT). PLAYER BENEFITS We treat our team right We offer amazing benefits above and beyond the basics. We have an array of health plans to choose from (some as low as $0 per paycheck) that include programs for fertility and family planning, mental health support, and fitness benefits. We offer generous paid time off (PTO & sick leave), annual bonus and long-term incentive opportunities (based on performance), 401k with up to a 5% match, commuter benefits, pet insurance, and more - check out all our benefits here: FanDuel Total Rewards. *Benefits differ across location, role, and level. FanDuel is an equal opportunities employer and we believe, as one of our principles states, "We are One Team!". As such, we are committed to equal employment opportunity regardless of race, color, ethnicity, ancestry, religion, creed, sex, national origin, sexual orientation, age, citizenship status, marital status, disability, gender identity, gender expression, veteran status, or any other characteristic protected by state, local or federal law. We believe FanDuel is strongest and best able to compete if all employees feel valued, respected, and included. FanDuel is committed to providing reasonable accommodations for qualified individuals with disabilities. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please email ********************. The applicable salary range for this position is $78,000 - $97,000 USD, which is dependent on a variety of factors including relevant experience, location, business needs and market demand. This role may offer the following benefits: medical, vision, and dental insurance; life insurance; disability insurance; a 401(k) matching program; among other employee benefits. This role may also be eligible for short-term or long-term incentive compensation, including, but not limited to, cash bonuses and stock program participation. This role includes paid personal time off and 14 paid company holidays. FanDuel offers paid sick time in accordance with all applicable state and federal laws. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. #LI-Hybrid "}
    $78k-97k yearly 3d ago
  • Healthcare Fraud Investigator - Medicare

    Orchard 4.7company rating

    Investigator job in Los Alamitos, CA

    Healthcare Fraud Investigator - Medicare Los Alamitos, CA hybrid (OR) Work from Home in CA, AZ, ID, NV, OR, UT, or WA @Orchard LLC is retained by a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Our Client is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities. Ensures the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions. Adheres to industry regulations and policies for managerial follow-up. Analyzes data in order to effectively assess the validity of claims. Provides accurate recommendations to management for claim resolution and closure. Documents and inputs all findings, while preparing comprehensive reports that may be used for legal or audit/investigative purposes. Essential Duties and Responsibilities: Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity. Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed. Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements. Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities, safeguarding the integrity of the claims process. Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives on claims. Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards. Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates. Assists in providing training and support to other auditors/investigators, contributing to the continuous improvement of investigative processes. Education and /or Skills and Experience Required: Minimum Bachelor's Degree Minimum of 2-4 years experience in fraud investigation/detection; 5-7 years experience preferred Must possess prior experience in federal or state healthcare programs or a related field that demonstrates expertise in reviewing, analyzing, and making appropriate decisions related to fraud, waste and abuse. Preferred Skills/Experience: Certified Fraud Examiner or Accredited Healthcare Anti-Fraud Investigator Prior successful experience with CMS and OIG/FBI or similar agencies Medicare investigation experience strongly preferred If you match the requirements for this opportunity and believe you have the experience and talent to succeed in the role, we need to hear from you! Compensation for the role of Investigator will be determined based on experience and qualifications. The salary range is expected to be $64,000 - $80,000, plus benefits. Established in 2010, @Orchard LLC, also known as, Talent Orchard has an exceptional reputation, providing staffing solutions to time-sensitive, talent scarcity issues to deliver better talent management ROI. Our specialty lies in the critical area of program talent acquisition and resource management, not in one narrow skillset, but across many areas of technical and functional delivery. To learn more about our other exciting opportunities, visit our Jobs Page at ****** Orchard.com .
    $64k-80k yearly 21d ago
  • Special Investigations Unit - Investigator II

    IEHP 4.7company rating

    Investigator job in Rancho Cucamonga, CA

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Special Investigations Unit Investigator II investigates and analyzes incidents of suspected fraud, waste, and abuse in accordance with regulatory requirements. The Special Investigations Unit Investigator II is responsible for conducting full investigations to proactively prevent, detect, and correct suspected and identified issues of fraud, waste, and abuse in the health care environment, including reporting to State and/or Federal regulatory agencies. The incumbent makes potential fraud, waste, or abuse determinations by utilizing a variety of sources including data analytics to detect unusual billing. The Special Investigations Unit Investigator II conducts monitoring and supports the Plan's Fraud, Waste and Abuse Program (FWA) to ensure compliance with State and/or Federal contracts, laws, regulations, and guidance set forth by the Centers for Medicare and Medicaid Services (CMS), the United States Health and Human Services Office of the Inspector General (HHS-OIG), the California Department of Managed Health Care (DMHC), and the California Department of Health Care Services (DHCS). Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary. Hybrid schedule. CalPERS retirement. State of the art fitness center on-site. Medical Insurance with Dental and Vision. Life, short-term, and long-term disability options Career advancement opportunities and professional development. Wellness programs that promote a healthy work-life balance. Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Identify, investigate, and analyze instances of alleged Fraud, Waste and Abuse (FWA) in accordance with regulatory requirements. Develop leads presented to the SIU to assess and determine whether potential FWA is corroborated by evidence. Conduct both preliminary assessments of FWA allegations, and end to end full investigations, including but not limited to witness interviews, background checks, data analytics to identify outlier billing behavior, contract and program regulation research, provider and member education, findings identification, develop recommendations, preparation of overpayment identifications, and closure of investigative cases. Prepare detailed preliminary and extensive investigation referrals to Federal and/or State regulatory and/or law enforcement agencies when potential FWA is identified as required by regulatory and/or contract requirements. Render provider education on appropriate practices (e.g., coding) as appropriate based on national or local guidelines, contractual, and/or regulatory requirements. Prepare audit results letters to providers when overpayments are identified. Prepare and conduct in-depth complex interviews relevant to investigative plan. Present, support, and defend investigative research to seek approval for formal corrective actions. Establish and maintain relationships with Federal and State law enforcement agencies, task force members, other company SIU staff and external contacts involved in fraud investigation, detection and prevention. Support regulatory communication requests as required, including providing claims data analysis, medical policy guidelines, and other documents/information. Support the FWA Program's short and long-term goals, as developed by Management, to prevent, detect, and correct issues of fraud, waste, and abuse. Review the FWA Program's policies and procedures, guidelines, practices, templates, and tools and make recommendations for revisions, as identified. Identify potential risks, non-compliance and/or alleged violations within the Plan or with external partners and issue root cause analysis/corrective action plans, as appropriate. Collaborate with internal partners on FWA intelligence and initiatives and assist with tracking and trending to identify potential fraud, waste, and abuse. Coordinate with Compliance Auditors as it relates to FWA issues and help implement process improvement measures to prevent, correct, and mitigate those risks in the future. Perform any other duties as assigned to ensure Plan operations are successful. Qualifications Education & Requirements Four (4) or more years relevant professional experience in a health care environment, with an emphasis in fraud, waste, and abuse investigations, including Federal and State reporting requirements Experience in health care fraud investigation, detection, and/or healthcare related specialty including but limited to; Pharmacy, DEM, Mental Health, Behavioral Health, Hospice, Home Health, claims, or claims processing preferred Bachelor's degree from an accredited institution In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position This experience is in addition to the minimum years listed in the Experience Requirements above Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), or similar certification/licensure preferred Key Qualifications Strong knowledge of Managed Care, Medi-Cal, and Medicare programs as well as Marketplace Compliance program principles and practices of managed care. Knowledge of federal and state guidelines as well as ICD, CPT, HCPCS, coding Excellent verbal and written communication skills with thorough documentation, composing detailed investigative reports and professional internal and external correspondence Interpersonal and presentation skills to communicate with internal departments and external agencies Demonstrated analytical, problem solving, and resolution skills Strong organizational skills and attention to detail. Proficiency in Microsoft Office programs including, but not limited to: Word, Excel, PowerPoint, Outlook, and Access Demonstrated proficiency in data mining and the use of data analytics to detect fraud, waste, and abuse, including the utilization of pivot tables, formulas, and trending Proven ability to: Work independently and collaboratively within a team environment. Apply knowledge, and address situations appropriately with minimal guidance Manage multiple projects with competing deadlines and changing priorities Research, comprehend and interpret various state specific Medicaid, Federal Medicare, and ACA/Exchange laws, rules and guidelines Identify, research and comprehend medical standards, healthcare authoritative sources and apply knowledge to investigative approach Minimal physical activity; may include standing, walking, sitting lifting, and pushing and carrying up to 25 lbs Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA) Pay Range USD $80,059.20 - USD $106,059.20 /Yr.
    $80.1k-106.1k yearly Auto-Apply 45d ago
  • Fraud Investigator

    Blueprint30 LLC

    Investigator job in San Dimas, CA

    ADP is hiring a Senior Fraud, Client Svc & Prod Supt Consultant - Wisely Card Product in our Employee Financial Solutions organization. The Senior Fraud Analyst serves as a technical expert and investigative resource for the Wisely Card product. This role is responsible for in-depth analysis of complex fraud cases, advanced data analysis and reporting, and providing consultative support to internal teams and external partners. The ideal candidate will leverage strong Excel skills and investigative expertise to resolve issues, improve processes, and support operational excellence. Ready to #MakeYourMark? Apply now! WHAT YOU'LL DO: Responsibilities Conduct in-depth investigations of complex fraud cases, using advanced analytical and investigative techniques Utilize strong Excel skills for data analysis, reporting, and metrics to identify trends and support business decisions Assist with developing, implementing, and optimizing fraud rules (including Feedzai) in collaboration with vendors and internal stakeholders Provide second-tier support and subject matter expertise to internal teams and external partners Develop and maintain reports, dashboards, and presentations to communicate findings and recommendations Collaborate with vendors and internal stakeholders to optimize fraud prevention strategies and resolve issues Identify process gaps and propose solutions to enhance fraud detection and mitigation Support compliance initiatives, audits, and regulatory reporting as required Communicate effectively with senior leaders to provide updates and recommendations Mentor colleagues and share best practices in fraud investigation and analytics Act as a resource for project-oriented assignments and cross-functional initiatives TO SUCCEED IN THIS ROLE: Requirements This role is located in our San Dimas, CA office. We support a hybrid working arrangement (3 days in the office minimum with 2 days at home). 5+ years of experience in fraud investigation, risk management, or compliance Strong Excel skills and technical proficiency in data analysis and reporting Demonstrated expertise in investigative techniques and problem-solving Experience supporting internal and external stakeholders in a complex business environment Experience with fraud monitoring, fraud detection and interpretation. Experience with fraud rules development, and optimization, including Feedzai or similar tools. Excellent written and verbal communication skills, including the ability to communicate with Senior Leadership and cross-functional partners Ability to work independently and manage multiple priorities Proven ability to lead projects and drive operational changes Visionary mindset with the ability to anticipate issues, and implement system changes A college degree is great but not required. What's more important is having the skills to do the job. Other acceptable experiences could include: Experience noted above, OR Military Experience. We recognize and appreciate the unique talents and experiences Veterans bring to the table. We value the discipline, commitment, and problem-solving abilities you developed and are excited to provide an environment where you can continue to make a meaningful impact
    $47k-78k yearly est. 20h ago
  • Fraud Investigator

    Adpcareers

    Investigator job in San Dimas, CA

    ADP is hiring a Senior Fraud, Client Svc & Prod Supt Consultant - Wisely Card Product in our Employee Financial Solutions organization. The Senior Fraud Analyst serves as a technical expert and investigative resource for the Wisely Card product. This role is responsible for in-depth analysis of complex fraud cases, advanced data analysis and reporting, and providing consultative support to internal teams and external partners. The ideal candidate will leverage strong Excel skills and investigative expertise to resolve issues, improve processes, and support operational excellence. Ready to #MakeYourMark? Apply now! WHAT YOU'LL DO: Responsibilities Conduct in-depth investigations of complex fraud cases, using advanced analytical and investigative techniques Utilize strong Excel skills for data analysis, reporting, and metrics to identify trends and support business decisions Assist with developing, implementing, and optimizing fraud rules (including Feedzai) in collaboration with vendors and internal stakeholders Provide second-tier support and subject matter expertise to internal teams and external partners Develop and maintain reports, dashboards, and presentations to communicate findings and recommendations Collaborate with vendors and internal stakeholders to optimize fraud prevention strategies and resolve issues Identify process gaps and propose solutions to enhance fraud detection and mitigation Support compliance initiatives, audits, and regulatory reporting as required Communicate effectively with senior leaders to provide updates and recommendations Mentor colleagues and share best practices in fraud investigation and analytics Act as a resource for project-oriented assignments and cross-functional initiatives TO SUCCEED IN THIS ROLE: Requirements This role is located in our San Dimas, CA office. We support a hybrid working arrangement (3 days in the office minimum with 2 days at home). 5+ years of experience in fraud investigation, risk management, or compliance Strong Excel skills and technical proficiency in data analysis and reporting Demonstrated expertise in investigative techniques and problem-solving Experience supporting internal and external stakeholders in a complex business environment Experience with fraud monitoring, fraud detection and interpretation. Experience with fraud rules development, and optimization, including Feedzai or similar tools. Excellent written and verbal communication skills, including the ability to communicate with Senior Leadership and cross-functional partners Ability to work independently and manage multiple priorities Proven ability to lead projects and drive operational changes Visionary mindset with the ability to anticipate issues, and implement system changes A college degree is great but not required. What's more important is having the skills to do the job. Other acceptable experiences could include: Experience noted above, OR Military Experience. We recognize and appreciate the unique talents and experiences Veterans bring to the table. We value the discipline, commitment, and problem-solving abilities you developed and are excited to provide an environment where you can continue to make a meaningful impact
    $47k-78k yearly est. 20h ago
  • Lead Investigator, Special Investigative Unit-(kentucky)

    Molina Talent Acquisition

    Investigator job in Long Beach, CA

    Under direct supervision of the Manager, SIU, the Team Lead is responsible to lead a small team of investigators and provide oversight on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight and guidance throughout the life of an investigation as well as QA reviews and approvals. In addition to leading a team of investigators and analysts, the Team Lead will ensure the Manager is aware of any major case developments, and ensure cases are being investigated according to the SIU's standards. Position must have thorough knowledge of Medicaid/Medicare/Marketplace health coverage audit policies and be able to apply them in ensuring program compliance via payment integrity programs. The position must have the ability to determine correct coding, documentation, potential fraud, abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare providers that bill Medicaid/Medicare/Marketplace. KNOWLEDGE/SKILLS/ABILITIES Ensure investigators are managing their cases effectively and in accordance with SIU policies, processes, quality standards, and procedures. Ensure that investigators are managing their respective State Reporting requirements and assignments effectively and timely. Manage the flow of day-to-day investigations. Perform assessment that QA measures were complete and signed-off Provide guidance to investigators as needed on investigative techniques, tools, or strategy. Effectively investigate and manage complex and non-complex fraud allegations. Develop and maintain relationships with key business units within specific product line and geographic region. Provides direction, instructions, and guidance to Investigative team, particularly in the absence of the SIU Manager. Provide training to team members as needed. Communicate clear instructions to team members, listen to team members' feedback. Monitor team members' participation to ensure the training provided is effective, and if any additional training is needed. Create, edit, and update assigned reports to apprise the company on the team's progress. Distribute reports to the appropriate personnel. JOB QUALIFICATIONS Required Education High School/GED Associates degree or bachelor's degree in Health Information Management, Health Care Administration, Finance, Criminal Justice, Law Enforcement, or related field (applicable FWA experience would be accepted in lieu of education experience) Required Experience Associates degree or bachelor's degree in Health Information Management, Health Care Administration, Finance, Criminal Justice, Law Enforcement, or related field (applicable FWA experience would be accepted in lieu of education experience) At least five (5) years' experience working in a Managed Care Organization or health insurance company Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews Proven investigatory skill; ability to organize, analyze, and effectively determine risk with corresponding solutions; ability to remain objective and separate facts from opinions Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems Understanding of datamining and use of data analytics to detect fraud, waste, and abuse Proven ability to research and interpret regulatory requirements Effective interpersonal skills and customer service focus; ability to interact with individuals at all levels Excellent oral and written communication skills; presentation skills with ability to create and deliver training, informational and other types of programs Advanced skills in Microsoft Office (Word, Excel, PowerPoint, Outlook), SharePoint and Intra/Internet as well as proficiency with incorporating/merging documents from various applications Strong logical, analytical, critical thinking and problem-solving skills Initiative, excellent follow-through, persistence in locating and securing needed information Fundamental understanding of audits and corrective actions Ability to multi-task and operate effectively across geographic and functional boundaries Detail-oriented, self-motivated, able to meet tight deadlines Ability to develop realistic, motivating goals and objectives, track progress and adapt to changing priorities Energetic and forward thinking with high ethical standards and a professional image Collaborative and team-oriented Required License, Certification, Association Valid driver's license required. Preferred Experience Healthcare Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Examiner (AHFI) and/or Certified Fraud Examiner (CFE) preferred. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJCorp #LI-AC1
    $48k-80k yearly est. Auto-Apply 15d ago
  • Healthcare Fraud Investigator

    Contact Government Services, LLC

    Investigator job in Los Angeles, CA

    Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include:- Review, sort, and analyze data using computer software programs such as Microsoft Excel.- Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.).- Develop HCF case referrals including, but not limited to:- Ensure that HCF referrals meet agency and USAO standards for litigation.- Analyze data for evidence of fraud, waste and abuse.- Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence.- Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings.- Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc. - Assist conducting witness interviews and preparing written summaries. Qualifications:- Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field.- Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.- Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.- Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data).- Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy.- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.- Experience and expertise in performing the requisite services in Section 3.- Must be a US Citizen.- Must be able to obtain a favorably adjudicated Public Trust Clearance.Preferred qualifications:- Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3.- Relevant experience working with a federal or state legal or law enforcement entity. #CJ
    $47k-78k yearly est. Auto-Apply 60d+ ago
  • As Needed Field Investigator- Long Beach, CA

    J T Becker & Co

    Investigator job in Long Beach, CA

    Becker & Company is seeking skilled and experienced Field Investigators to join our team on an "as needed" basis. This role is perfect for a licensed investigator looking for flexible hours while providing expert investigative services. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability and aimed at mitigating expenses for our clients and delivering high-quality results. We are seeking a detail-oriented and proactive investigator to join our team. The ideal candidate will conduct a variety of investigations, including Surveillance and Special Investigations Unit (SIU) assignments, within an assigned geographical area. Surveillance assignments require the investigator to obtain videotape documentation of the subject and for SIU assignments the investigator must complete the assignment as per the instructions given by the case manager. Key Responsibilities: Adhere to specific requirements of an assignment based upon the case manager's instructions Review all case materials prior to conducting investigative activity Complete video surveillance on identified individuals for the allotted amount of time and utilizes established investigative techniques to secure covert video footage Conduct investigations such as securing recorded statements, scene inspections, activity checks and securing documents as assigned Complete written notes on each case assignment in a timely manner Submit all videotaped results, photographs, and digital recordings via e-mail by the next business day Meet established deadlines set by the client Communicate effectively with the assigning case manager with regularity regarding the progress of assignments Ensure confidentiality of all information obtained Requirements Possess a valid state issued driver's license Possess a current private investigator license (if applicable) Must be dependable and able to meet deadlines Must be a self-starter capable of working with limited supervision Possess investigative tools (Laptop, Video Cameras, Digital Recorder, etc.) Possess strong writing and verbal communication skills Experience conducting surveillance as a field investigator Experience completing SIU claim investigations Possess a reliable vehicle
    $37k-60k yearly est. 60d+ ago
  • Special Investigations Unit (SIU) - Field Investigator

    Ethos Risk Services

    Investigator job in Los Angeles, CA

    Job Description ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making for our clients. JOB SUMMARY: Our dynamic Ethos team is seeking a Special Unit Investigations (SIU) Field Investigator to conduct field investigations, gather and analyze evidence, and produce detailed reports that support claims decisions. You'll work both independently and collaboratively, often traveling to accident scenes, interviewing witnesses, and uploading documentation into our claims system. KEY RESPONSIBILITIES: Scene Investigations: Conduct thorough on-site investigations of accidents and property losses. Interviews & Statements: Conduct in-person interviews and obtain accurate, detailed statements from all parties involved. Online Research: Gather case information through digital sources and background checks. Report Writing: Draft thorough, detailed investigative reports summarizing findings and observations. Case Documentation: Conduct in-person interviews and obtain accurate, detailed statements from all parties involved, and retrieve relevant documents to support investigative findings. Case Management: Track case progress, time, and expenses accurately within Ethos systems. Fraud Detection: Recognize compensability issues, misrepresentation, and other red flags in claims. Client Communication: Maintain professional contact with clients and claim handlers throughout the investigation process. QUALIFICATIONS: Education: Associate's or Bachelor's degree in Criminal Justice or a related field preferred. Experience: Minimum of 2 years of SIU experience with an investigative firm or insurance carrier, working across various lines of business such as liability, auto, and property. Former military or law enforcement background preferred. Licenses/Certifications: Active Private Investigator license or willingness to obtain one (where required by state). Active driver's license and valid auto insurance. Other Requirements: A well-maintained and reliable vehicle for exclusive use. SIU equipment, including a recorder and a high-quality digital camera. A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks. WORKING CONDITIONS: While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be required. Occasional weekend work may be required to align with case demands and or/client requests. Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic. A background check will be conducted, in accordance to the local state law and regulations. Job Posted by ApplicantPro
    $48k-81k yearly est. 21d ago
  • Surveillance Investigator

    Security Director In San Diego, California

    Investigator job in Orange, CA

    Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference. Job Description Allied Universal is hiring a Surveillance Investigator. The Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an Insurance claim. Must possess a valid driver's license with at least one year of driving experience Company credit card to cover fuel and travel expenses Pay Rate: $20 - $24 / hr RESPONSIBILITIES: Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability Utilize various surveillance techniques and equipment to monitor subjects covertly Document and report observations, activities, and any relevant information in a clear and concise manner Collaborate with other investigators and law enforcement agencies as needed to gather information and coordinate efforts Maintain confidentiality and adhere to legal and ethical standards in conducting surveillance operations QUALIFICATIONS (MUST HAVE): High school diploma or equivalent Post offer, must be able to successfully complete the Allied Universal Investigations' training/orientation course Prior educational or professional exposure to witness interviews or video monitoring Prior educational or professional incident reporting and/or investigations experience Flexibility to work varied and irregular hours/days including weekends and holidays Ability to type reports in Microsoft Word format with minimal grammatical and punctuation errors Proficient in utilizing laptop computers, video cameras and cell phones Capable of maintaining focus and multitasking effectively in a dynamic environment Demonstrated ability to manage stressful situations with composure and professionalism Ability to work in a very independent environment PREFERRED QUALIFICATIONS (NICE TO HAVE): Associate's Degree or higher, preferably in Criminal Justice Security/Loss Prevention experience Military experience Law enforcement experience Prior insurance investigations experience BENEFITS: Medical, dental, vision, basic life, AD&D, and disability insurance Enrollment in our company's 401(k)plan, subject to eligibility requirements Seven paid holidays annually, sick days available where required by law Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law Closing Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: *********** If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices. Requisition ID 2025-1478349
    $20-24 hourly Auto-Apply 14d ago
  • Field and in-house private investigator

    USA Express Legal & Investigative Service Inc.

    Investigator job in Los Angeles, CA

    Job DescriptionBenefits: 401(k) Health insurance Looking for private investigator or anyone is in training to become an investigator to handle field assignments for personal injury cases. Training will be provided. Immediate opening. We pay hourly rate plus IRS applicable mileage if not driving the company vehicle. Job duties will involve conducting field investigation, canvasing area, speaking with witnesses, etc. This is an immediate opening.
    $54k-99k yearly est. 1d ago
  • Healthcare Fraud Investigator - Medicare

    Orchard 4.7company rating

    Investigator job in Los Alamitos, CA

    Job Description Healthcare Fraud Investigator - Medicare Los Alamitos, CA hybrid (OR) Work from Home in CA, AZ, ID, NV, OR, UT, or WA @Orchard LLC is retained by a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Our Client is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities. Ensures the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions. Adheres to industry regulations and policies for managerial follow-up. Analyzes data in order to effectively assess the validity of claims. Provides accurate recommendations to management for claim resolution and closure. Documents and inputs all findings, while preparing comprehensive reports that may be used for legal or audit/investigative purposes. Essential Duties and Responsibilities: Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity. Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed. Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements. Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities, safeguarding the integrity of the claims process. Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives on claims. Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards. Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates. Assists in providing training and support to other auditors/investigators, contributing to the continuous improvement of investigative processes. Education and /or Skills and Experience Required: Minimum Bachelor's Degree Minimum of 2-4 years experience in fraud investigation/detection; 5-7 years experience preferred Must possess prior experience in federal or state healthcare programs or a related field that demonstrates expertise in reviewing, analyzing, and making appropriate decisions related to fraud, waste and abuse. Preferred Skills/Experience: Certified Fraud Examiner or Accredited Healthcare Anti-Fraud Investigator Prior successful experience with CMS and OIG/FBI or similar agencies Medicare investigation experience strongly preferred If you match the requirements for this opportunity and believe you have the experience and talent to succeed in the role, we need to hear from you! Compensation for the role of Investigator will be determined based on experience and qualifications. The salary range is expected to be $64,000 - $80,000, plus benefits. Established in 2010, @Orchard LLC, also known as, Talent Orchard has an exceptional reputation, providing staffing solutions to time-sensitive, talent scarcity issues to deliver better talent management ROI. Our specialty lies in the critical area of program talent acquisition and resource management, not in one narrow skillset, but across many areas of technical and functional delivery. To learn more about our other exciting opportunities, visit our Jobs Page at ****** Orchard.com .
    $64k-80k yearly 21d ago
  • Healthcare Fraud Investigator

    Contact Government Services, LLC

    Investigator job in Los Angeles, CA

    Job DescriptionHealthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include:- Review, sort, and analyze data using computer software programs such as Microsoft Excel.- Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.).- Develop HCF case referrals including, but not limited to:- Ensure that HCF referrals meet agency and USAO standards for litigation.- Analyze data for evidence of fraud, waste and abuse.- Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence.- Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings.- Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc. - Assist conducting witness interviews and preparing written summaries. Qualifications:- Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field.- Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.- Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.- Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data).- Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy.- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.- Experience and expertise in performing the requisite services in Section 3.- Must be a US Citizen.- Must be able to obtain a favorably adjudicated Public Trust Clearance.Preferred qualifications:- Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3.- Relevant experience working with a federal or state legal or law enforcement entity. #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
    $47k-78k yearly est. 19d ago

Learn more about investigator jobs

How much does an investigator earn in Costa Mesa, CA?

The average investigator in Costa Mesa, CA earns between $56,000 and $159,000 annually. This compares to the national average investigator range of $42,000 to $119,000.

Average investigator salary in Costa Mesa, CA

$94,000

What are the biggest employers of Investigators in Costa Mesa, CA?

The biggest employers of Investigators in Costa Mesa, CA are:
  1. Columbia Bank
  2. Frasco, Inc.
  3. Ethos Risk Services
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