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  • SIU Investigator - Atlanta, GA

    Delta Group 3.8company rating

    Investigator job in Atlanta, GA

    Delta Group is a privately held, national investigative firm established in 1983 and headquartered in Buford, Georgia. As pioneers of unmanned surveillance technology, Delta Group's eRemote technology is an industry recognized product that continues to evolve and produce game-changing results. With more than 500 direct employees nationwide, our domestic footprint is large enough to matter and small enough to care. We pride ourselves on developing and retaining professional staff while maintaining diversity within our team. Our executive leadership team brings over 100 years of combined experience leading national carrier fraud divisions, state fraud prosecutorial offices, claims and program management divisions, and investigative operations. For over 41 years, our investigative resources have helped organizations reduce risk, improve profitability, and increase revenue within the insurance industry. Our expert employees are located throughout the United States, executing investigations for all types of claims including but not limited to, workers' compensation, liability, auto, property, disability, and corporate investigations, regardless of size. Come join our talented team and our commitment to people, innovation and results. The Special Investigation Unit of Delta Group investigates and identifies questionable and suspicious claims for our partners, communicating with claims personnel, insurance carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and deter fraud. The candidate should have extensive experience with claims for all lines of insurance, with a heavy emphasis on Workers' Compensation claims. JOB DUTIES: Conduct timely investigations including recorded statements and interviews of claimants, witnesses, and employers. Provide timely status updates to case manager and client. Timely and clear documentation of the claim files. Maintain highest level of confidentiality and professionalism. Develop appropriate investigative action plan. Ensure accuracy, quality and timeliness of the evidence gathered during an investigation as well as compliance with all applicable laws, legal codes, and governing agencies. Provide Claim Adjuster with timely investigation results and document investigative findings. Determine whether additional evidence is required including but not limited to accident reports, accident scene reconstructions, witness statements, police reports, expert opinion, etc. Provide recommendations and decisions surrounding investigative efforts. Perform detailed database queries on SIU investigations to include analysis and organization of critical data to assist during the assigned investigation. Be able to evaluate State compliance referrals, as applicable, when questionable or suspicious activity is identified. Maintain active membership in professional organizations that provide SIU assistance and resources.. Establish and maintain relationships with law enforcement, government regulatory agencies and insurance industry personnel assisting when needed or required. JOB REQUIREMENTS: Strong investigative skills necessary. Must be detail oriented. Ability to recognize patterns of inconsistencies that may be linked to fraudulent activity. Must have ability to interact with clients, repair shops and appraisers, and employers. Ability to work independently. Excellent verbal and written communication skills. Good organization and time management skills. Demonstrate knowledge of tools and techniques needed for conducting insurance claims investigations. Demonstrate proficiencies with computer software, Word, Excel, Outlook and Teams. Must have the ability to utilize an objective perspective when performing tasks. EQUIPMENT NEEDED: Laptop Computer Cell Phone Audio Recording device with download capability Digital Camera Tape measure EDUCATIONAL REQUIREMENTS: CFE or FCLS designations preferred 5-10 years' experience in claims and SIU investigations preferred The final job level and annual salary will be determined based on the education, qualification, knowledge, skills, ability, and experience of the final candidate(s), and calibrated against relevant market data and internal team equity. Delta Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex (including pregnancy, sexual orientation, gender identity / expression), national origin or ancestry, genetic information (including family medical history), physical or mental disability, protected veteran status, or any other characteristic protected under federal, state or local law, where applicable, and those with criminal histories will be considered in a manner consistent with applicable state and local laws.
    $46k-62k yearly est. 60d+ ago
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  • SIU Investigator P&C - Post-bind (Mid-level)

    USAA 4.7company rating

    Investigator job in Atlanta, GA

    Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We are looking for a SIU Investigator (mid-level). This is a "Desk" position. Besides solid experience as an SIU Investigator within P&C, you will have strong underwriting skillset as part of working within underwriting, investigating post-bind or part of an underwriting investigative team. Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. This role is remote eligible. You can live anywhere in the Continental US. There may be occasional business travel involved. What you'll do: Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims. Participates in the development of fraud prevention strategies. Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures. Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims. Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools. Makes recommendations within defined authority guidelines. Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome. Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention. May serve as a resource team member on specific matters through demonstrated skill or training. Assists with the delivery of fraud awareness training initiatives in a defined environment. Handles CAT duty responsibilities as business requires. Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. What you have: High School Diploma or General Equivalency Diploma (GED). 2+ years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4+ years prior investigative law enforcement (to include military) or relevant fraud industry investigation experience. Proven investigatory skills. Experience obtaining statements from various parties to incidents, witnesses, and suspects. Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud. Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems. Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems. Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology. What sets you apart: Strong underwriting skillset as part of working within underwriting, investigating post-bind or part of an underwriting investigative team. Strong understanding of auto and property policy language to proactively identify potential misrepresentations before a claim is filed. Strong report writing and presentation skillset. SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement Investigations OR Military Investigative experience. Designations such as CFE, CIFI, SCLA, ACLS, FCLS, LPCS, AIC, CPCU, CCLS, or other. US military experience through military service or a military spouse/domestic partner Compensation range: This is an hourly position. However, the annualized salary range for this position is: $77,120 - $147,390 USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, F-1, STEM OPT Training Plans, etc.). Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $77.1k-147.4k yearly 19h ago
  • Criminal Investigations Analyst

    Forsyth County, Ga 4.2company rating

    Investigator job in Cumming, GA

    Information The purpose of this classification is to research, assemble, analyze, and interpret raw intelligence from multiple sources to identify criminal trends, support investigations, and provide specialized analytical and technical support. Essential Functions The following duties are representative of the position and are not intended to be an exhaustive list. Additional duties may be assigned as necessary. Applies advanced technical and analytical skills to collect, research, and evaluate complex data in support of criminal investigations and sensitive projects. Utilizes social media and open-source platforms to identify criminal activity, track trends, and develop actionable intelligence related to individuals, organizations, and emerging threats. Detects and analyzes new and evolving methods of communication and technology used in criminal activity, including mobile applications, encrypted communication, internet-based tools, and the dark web. Identifies and maps organizational hierarchies within criminal enterprises to assist investigators in prioritizing investigative focus and resource allocation. Develops visual intelligence products such as charts, timelines, maps, and link analyses to support investigators, prosecutors, and juries in understanding case relationships and structures. Prepares and disseminates intelligence bulletins and strategic reports to internal personnel and partner agencies. Participates in interviews with suspects, witnesses, and informants; prepares detailed analytical summaries and reports of findings. Provides real-time support to deputies and investigators, including live tracking, license plate analysis, and other data-driven operational assistance. Operates and manages various analytical and investigative software systems including but not limited to Microsoft Office Suite, Pen-Link, i2 Analyst Notebook. Coordinates with local, state, and federal partners for information-sharing and collaborative crime analysis efforts. Prepares and delivers presentations and briefings to internal command staff, elected officials, and external agencies. Maintains strong communication across organization to collect and exchange investigative intelligence and ensure consistency in data-driven policing efforts. Documents investigative activity through supplemental reports as required. Conducts threat analysis to identify, assess, and communicate intelligence gaps and emerging threats in real time. May be required to testify in court regarding analytical findings and intelligence processes. Conducts financial and transactional analysis to identify irregularities and summarize complex financial data. Must successfully complete and maintain required GCIC/NCIC certifications. DESIRABLE SKILLS, KNOWLEDGE, AND EXPERIENCE Strong knowledge of digital media technologies, file systems, computer hardware/software, and mobile device applications. Familiarity with digital forensic data acquisition, internet browsers, email systems, and basic networking concepts. Proficiency with Microsoft Office applications and analytical tools (e.g., i2, Cellebrite, Pen-Link, Clearview AI). Ability to communicate clearly and effectively, both verbally and in writing. Exceptional organizational skills with the ability to manage multiple priorities independently. Problem-solving skills in identifying and resolving hardware, software, and analytical challenges. ADDITIONAL FUNCTIONS Classified as a Safety-Sensitive Position, subject to random drug and alcohol testing per Forsyth County policy. Provides technical assistance to investigators regarding digital evidence, search warrants, and analytical tools. Assists with administrative duties such as answering phones, data entry, file management, and preparing digital evidence. May be assigned to the Real Time Crime Center to assist with other duties. Performs other related duties as assigned. Minimum Qualifications Bachelor's degree in Criminal Justice, Mathematics, Computer Science, Business Administration, Statistics, Behavioral Science, Geographic Information Systems (GIS), or a related field. One (1) to two (2) years of relevant analytical or law enforcement experience; or an equivalent combination of education, training, and experience sufficient to perform the essential duties. Must successfully pass a comprehensive background investigation and polygraph examination. Must be at least 18 years of age. Must possess and maintain a valid Georgia driver's license. BENEFITS PROVIDED BY FORSYTH COUNTY TO FULL-TIME EMPLOYEES: Personal Leave Accrual Personal leave shall be accrued as follows: 0 - 4 Years - 20 days per year - 6.16 hours per pay period 5 - 14 Years - 25 days per year - 7.70 hours per pay period 15+Years - 30 days per year - 9.24 hours per pay period Observed Holidays New Year's Day, Martin Luther King Day, Memorial Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving (2), and Christmas (2). Medical Insurance The Forsyth County Board of Commissioners offers employees a choice of two medical plans offered by Aetna and a plan offered by Kaiser Permanente. * Aetna Choice POS II - $2000 Individual Deductible (Basic Plan) * Aetna Choice POS II - $1000 Individual Deductible (Plus Plan) * Kaiser Permanente HMO- $0 Individual Deductible Dental Insurance The Forsyth County Board of Commissioners offers two dental plans from Delta Dental: * Base $1,000 Plan * Buy-Up $1,500 Plan Vision Insurance The vision plan offered by Forsyth County Board of Commissioners is administered by Aetna and will offer office visit copays for exams, as well as copays for lenses, frames, and contacts. Basic Life & AD&D Insurance The Forsyth County Board of Commissioners recognizes the importance of basic life insurance for all of its employees. The Board provides term life insurance and accidental death and dismemberment (AD&D) protection for each full-time employee. This is a County-paid benefit. Disability Insurance - Short Term and Long Term 100% paid by Forsyth County. Eligibility begins date of hire. Short Term Disability - 60% of weekly earnings to a maximum of $1,000.00 a week. Eligibility begins 14 days after an accident or sickness and has a benefit period of 24 weeks. Long Term Disability - 60% of monthly earnings to a maximum of $5,000.00 a month. Eligibility begins at 26 weeks to coordinate with the end of Short Term benefits and continues 24 months (Own Occupation). Additional Life Insurance and AD&D Rates vary based on amount of coverage selected. Additional life insurance may be purchased for employee, spouse, and children. Retirement Plan (401K) Fully vested at five years of employment - 20% graduated vesting annually. Eligible to begin contributions immediately upon hire. Six Months through One Year of County Service Forsyth County matches your contributions, dollar for dollar, up to 5% of your pay. That's a 100% return on the first 5% of pay you save. Years One through Five Forsyth County "seeds" your account with 5% of your pay each year, and matches 100% of what you contribute, up to 5% of your pay. Years 5 through 10 The County continues its automatic "seed" contribution of 5% of pay, matches up to the first 5% of pay that you contribute, then adds a 50% match up to the next 5%. After 10 Years of Service You continue to receive a 100% County match on the first 5% of pay you contribute, and 50% on the next 5% of pay you save. But now, the automatic contribution the County makes to "seed" your account each year increases to 7.5% of your pay. 01 Do you have a Bachelor's degree in Criminal Justice, Mathematics, Computer Science, Business Administration, Statistics, Behavioral Science, Geographic Information Systems (GIS), or a related field? * Yes * No 02 Do you have at least one (1) year of relevant analytical or law enforcement experience? * Yes * No 03 Do you have a valid driver's license? * Yes * No 04 Are you at least 18? * Yes * No Required Question Employer Forsyth County Address 110 East Main Street Suite 230 Cumming, Georgia, 30040 Phone ************** Website ****************************************************
    $5k monthly 16d ago
  • Private Investigator - Company Vehicle Provided!

    Photofax 2.7company rating

    Investigator job in Atlanta, GA

    Job DescriptionSalary: $20-$25 Surveillance Investigator PhotoFax, Inc., a nationwide private detective agency, is currently hiring surveillance investigators to join our team in the Atlanta region. If you like to work autonomously in dynamic environments, surveillance investigations provide an exciting career path meant just for you! Join the PhotoFax team today and we provide the tools necessary to start your career as a Private Investigator. What your day will look like: Monitoring, pursuing, and documenting individuals in a covert manner from a company issued-fully customized surveillance vehicle Pre and post surveillance briefing with your case manager to discuss objectives, surveillance tactics, and case details Detailed reporting on daily case observations Uploading video evidence obtained to the company database Frequent Regional Travel (in the company issued vehicle) Click to view our recruiting video! What you will gain: Experience that will lead to other opportunities in: Investigations Law enforcement Upper claims management Growth within PhotoFax A company issued vehicle customized for surveillance and all equipment necessary to do the job Hands on training with our experienced trainers with 34 years of investigative knowledge Full health benefits package including matching 401K Performance based reviews and bonuses Paid overtime and travel Cell phone reimbursement What you need to apply: High school diploma or GED Clean driving record with minimal infractions Must currently reside in the greater Atlanta area Flexibility to work any day of the week including weekends and holidays Willingness to travel with frequent overnight stays No previous experience is necessary; we provide all training and licensing
    $20-25 hourly 20d ago
  • Investigator

    Frasco 4.1company rating

    Investigator job in Atlanta, GA

    Part-time Description Job Type: Part-Time, Billable Hours, Non-exempt Reports To: Regional Manager Compensation: Hourly Rate: $22 - $28 per hour (Weekly Pay) Commensurate with experience and performance Travel Time: Travel commute time is compensated at 100% of regular hourly rate, after reasonable commute Mileage Reimbursement: $0.50 per mile Paid Administrative Time: Paid at regular hourly rate Paid Training: Paid at regular hourly rate The Interviews Team is looking for an Investigator to join our team on a full-time or part time if feasible. This role involves conducting thorough insurance claims investigations, which include performing scene investigations to collect photo and video evidence from accident locations. Additionally, this position requires the handling of document signings and retrievals, conducting wellness checks, and submitting daily updates on the work performed for each case. Preparing and dictating investigation reports is also a key responsibility. Essential job functions include, but are not limited to: Conducting insurance claims investigations, including taking recorded claimant and witness statements as well as performing scene investigations Completing multiple types of complex claims investigations Reviewing assignments and supporting documentation to determine case objectives and client expectations. Daily submission of updates regarding work performed on each case Maintaining a sufficient level of client billable hours Preparing and dictating detailed investigation reports Adhering to strict due dates 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 Investigator candidates must have: Strong attention to detail with commitment to accuracy and quality Ability to effectively communicate with others Ability to work independently Ability to work from a home-based office and work flexible hours Valid driver's license and vehicle Minimum auto insurance in the amount of $100,000 each person/$300,000 each accident bodily injury/$50,000 property damage Smartphone, printer, scanner, desktop/laptop computer with a good internet connection Ability to model behaviors that reflect Frasco's core values Capable of working independently, contacting clients, and strategizing about the best course of action to handle their needs, and be able to proceed accordingly Preferred Qualifications/Experience: Associate or Bachelor's Degree in Criminal Justice or related field Customer service experience 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 Equal Opportunity Employer PM18
    $22-28 hourly 9d ago
  • SIU Investigator

    Allied Universal Compliance and Investigations

    Investigator job in Atlanta, GA

    Overview 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 Special Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists investigate claims with red flags that suggest fraudulent behavior In relation to an Insurance claim. The SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for prosecution. Must possess a valid driver's license with at least one year of driving experience Georgia applicants must independently complete the 70-hour course necessary to receive a Private Investigator's license prior to applying. RESPONSIBILITIES: Independently investigate suspected fraudulent insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance Create and maintain detailed documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments as directed Produce professional and expert reports, memos, and letters that are clear, concise, and grammatically correct Run appropriate database indices if necessary and verify the accuracy of results found Independently develop a strategic plan to achieve assignment objectives, ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor QUALIFICATIONS (MUST HAVE): Must possess one or more of the following: Bachelor's degree in Criminal Justice High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud Ability to be properly licensed as a Private Investigator as required by the state where work Is completed Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards within their home state and designated regional area. Proficient in utilizing laptop computers and cell phones. Special Investigative Unit (SIU) Compliance knowledge Ability to type 40+ words per minute with minimum error Flexibility to work varied and irregular hours and days including weekends and holidays PREFERRED QUALIFICATIONS (NICE TO HAVE): Military experience Law enforcement Insurance administration experience Familiarity with California SIU regulations One or more of the following professional industry certifications: Certified Fraud Investigator (CFE) Certified Insurance Fraud Investigator (CIFI) Fraud Claim Law Associate (FCLA) Fraud Claim Law Specialist (FCLS) Certified Protection Professional (CPP) Associate in Claims (AIC) Chartered Property Casualty Underwriter (CPCU) 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 2025-1505534
    $42k-75k yearly est. 3d ago
  • Atlanta, GA SIU Investigator

    Lemieux & Associates

    Investigator job in Atlanta, GA

    Come grow with us! Lemieux & Associates, a national leader in the investigative industry, is seeking experienced SIU/Claims Investigators in the Atlanta, GA or surrounding area. This is a part-time position to start with the ability to turn into a full-time position for the right individual. The owners are entrepreneurial, experienced, field investigators, each with over 25 years of experience. We understand the job and never forgot our roots in the field. We are dedicated professionals with a motivational management style with proven ability to recruit, develop and direct highly successful teams that consistently excel. Requirements: You must be licensed as a Private Investigator in the state of Georgia, reside in the Atlanta or surrounding area and have complex SIU/Claims investigation experience. If you are not licensed as a Private Investigator and do not have SIU/Claims experience, please do not apply because we can't hire you. Responsibilities: Provide detailed accurate reports Obtain written and recorded statements Perform scene investigations Investigate property theft, vehicle theft, garaging issues and permissible use claims Ability to accurately photograph evidence i.e., accident scenes, vehicle damage, etc. Skills/Experience Experience conducting complex SIU/Claims cases is a must. Being a notary is highly preferred Experience conducting surveillance as a Private Investigator is preferred. Bi-lingual is a plus Associates/Bachelor, Degree in Criminal Justice or Related Field is a plus Ability and willingness to travel as necessary Flexibility to work varied/irregular hours and days Strong computer and Internet skills Must possess a valid state-issued driver's license Must possess a reliable vehicle, digital camera and computer with Windows Operating System, Microsoft Word and Internet connection Must have the personal pride to get your work product in on time Competitive starting pay Travel time compensation Report writing compensation FT positions are offered the following benefits: Medical, Dental, 401K, Paid Vacation and Paid Holidays
    $42k-75k yearly est. 5d ago
  • Investigator II

    Carebridge 3.8company rating

    Investigator job in Atlanta, GA

    Hours: Monday - Friday Travel: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Position Overview: Responsible for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent Medicaid claims. How You Will Make an Impact: * Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health plan, line of business and/or state * Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims * Effectively establish rapport and on-going working relationship with law enforcement * May interface internally with Senior level management and legal department throughout investigative process * May assist in training of internal and external entities * Assists in the development of policy and/or procedures to prevent loss of company assets Required Qualifications: * Requires a BA/BS and minimum of 3 years related experience; or any combination of education and experience, which would provide an equivalent background. Preferred Qualifications: * Healthcare experience strongly preferred * Fraud certification from CFE, AHFI, AAPC or coding certificates preferred * Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred * Health insurance, law enforcement experience preferred * Advanced Data analysis experience Strongly preferred * Advanced Microsoft Excel experience is a must Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $38k-70k yearly est. Auto-Apply 60d+ ago
  • Criminal Investigator - Organized Retail Crime

    State of Georgia 3.9company rating

    Investigator job in Atlanta, GA

    Office of The Attorney General Department of Law Prosecution - Investigator - Organized Retail Crime The mission of the Department of Law is to serve the citizens of the State of Georgia by providing legal representation of the highest quality to the agencies, officers and employees of state government and by honorably and vigorously carrying out the constitutional and statutory responsibilities of the Attorney General. The position filled through this announcement will serve in our Prosecution Division, which includes Gangs, Human Trafficking, Public Corruption, White Collar Crimes and Organized Retail Crime. Primary Duties & Responsibilities: Under general supervision, screens and investigates allegations of criminal wrongdoing that are within the jurisdiction of the agency; makes arrests, obtains and serves search warrants, and prepares cases for prosecution. Maintains and applies professional knowledge of current trends and developments related to work assignment. Responds to assignments and requests for assistance by reviewing documentation, conducting interviews of victims, witnesses and suspects, and gathering intelligence information. Obtains and executes search and arrest warrants. Follows appropriate laws, guidelines, and policies in maintaining the chain of custody of evidence. Collects, reviews, and evaluates physical and electronic evidence. Assists in identifying potential assets subject to seizure and may conduct asset seizures. Assists the appropriate entities and parties in submitting, organizing, analyzing, and processing items of evidence and other documentation for investigation and prosecutorial purposes. Demonstrates knowledge of computer software in creating databases, spreadsheets, graphs, presentations and all other computer skills necessary to conduct criminal investigations. Prepares thorough and accurate case reports for all investigative activities in a timely manner, including: reports documenting interviews of victims, witnesses and suspects and reports documenting the execution of search warrants and the seizure of evidence. Presents accurate courtroom testimony utilizing proper courtroom demeanor and assists prosecutors in coordinating pre-trial activities. Locates victims and witnesses for trial preparation and trial. Maintains assigned equipment based on Department policy and standards. Participates in seminars and professional meetings, including law enforcement intelligence meetings, when available and approved in advance. Maintains professional knowledge by reading up-to-date articles, books, and periodicals as well as attending available subject matter trainings. Interacts with all levels of state and local government in a way that promotes respect, encourages cooperation, and contributes to excellent performance. Maintains relationships and liaisons with other agencies, departments, and the public according to Division requirements. Maintains P.O.S.T. Certification and a valid driver's license; completes mandatory in-service training required each year; and fulfills firearms qualification as required. The above statements are intended to describe the general nature and level of work being performed by persons assigned to this title. They may not include all job duties performed by employees on this job title, and every position does not necessarily require these duties. Minimum Qualifications: * 2 years of criminal investigation experience * P.O.S.T. certification Preferred Qualifications: * Criminal justice or other job related degree from an accredited four-year college or university * Experience conducting Organized Retail Crime (ORC) related investigations to include interviews, surveillance and documentation * Exposure to and experience with RICO investigations and/or large-scale multi-codefendant investigations * Experience with social media and digital evidence-based investigations * Training from and/or experience working with Georgia Retailers Organized Crime Alliance (GROC) * To move forward in the recruiting process ALL applicants are required to: * Attach a current Resume * Cover Letter * Attach "Department of Law Employment Application" (click link to obtain: ************************************************* * Attach copies of official undergraduate transcripts- unofficial are accepted during hiring process. * If the file is too large to attach, please email the document(s) to ************* to include the position title - application material(s) in the subject line. Additional Information * Agency Logo: * Requisition ID: LAW0AL7 * Number of Openings: 1 * Shift: Day Job
    $29k-38k yearly est. 60d+ ago
  • Fraud Investigative Lead Supervisor

    Open 3.9company rating

    Investigator job in Atlanta, GA

    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 25d ago
  • Fraud Investigative Lead Supervisor

    Flutter Entertainment PLC

    Investigator job in Atlanta, GA

    :" 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 35d ago
  • SIU Investigator - Underwriting & Premium Fraud

    CNA Financial Corp 4.6company rating

    Investigator job in Atlanta, GA

    You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Under minimal direction, initiates and manages suspected fraudulent underwriting and insurance premium investigations involving the highest complexity matters. Provides advice, direction, and support to underwriters, auditors, business unit leadership, corporate investigations and other stakeholders across the organization on the detection, investigation, and litigation of suspected underwriting matters. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: * Leads the detailed analysis and completion of thorough and timely investigations of suspected underwriting fraud by following Best Practice Guidelines and collaborating with business stakeholders. * Develops and executes investigation strategy either independently or in collaboration with underwriting professionals, counsel, experts, insureds, and other stakeholders. * Manages investigation activities independently and/or coordinates/oversees vendor service partner activities in the field. * Maintains detailed, accurate and timely case records by following established Best Practices for file documentation and by creating comprehensive reports of investigative findings, and conclusions. * Makes recommendations for resolution by presenting evidence-based findings and proposing solutions of moderate to complex scope. * Identifies opportunities and participates in the design and implementation of process or procedural improvements. * Leads or directs efforts to build and enhance and oversees organizational capabilities by developing and delivering fraud awareness or regulatory compliance training and mentoring SIU staff. * Leads or directs the preparation of cases for appropriate reporting to outside agencies; leads or directs pursuit of criminal or civil actions through gathering and documenting relevant data, organizing and summarizing facts and testifying on behalf of the company in civil or criminal matters. * Continuously develops knowledge and expertise related to insurance fraud by keeping current on related law, regulations, trends, and emerging issues and participating in insurance fraud or related professional associations. May perform additional duties as assigned. Reporting Relationship Typically Manager or Director Skills, Knowledge and Abilities * Solid knowledge of property and casualty claim handling practices * Strong technical knowledge of practices and techniques related to investigations and fact finding. For roles focused in an area of specialty (medical provider investigations), strong technical knowledge of respective specialty practices is required. * Strong interpersonal, oral, and written communication skills; ability to clearly communicate complex issues * Ability to interact and collaborate with internal and external business partners, including outside agencies * Ability to work independently, exercise good judgment, and make sound business decisions * Detail oriented with strong organization and time management skills * Strong ability to analyze complex, ambiguous matters and develop effective solutions * Proficiency with Microsoft Office applications and similar business software, and understanding of relational databases information querying techniques * Ability to adapt to change and value diverse opinions and ideas * Developing ability to implement change * Ability to travel occasionally (less than 10%) Education and Experience * Bachelor's degree or equivalent professional experience. * Minimum of three to five years of experience conducting investigations in the area of a) insurance fraud, b) law enforcement, c) civil or criminal litigation, or d) similar field. * Professional certification or designation related to fraud investigations strongly preferred (e.g., CFE, CIFI, FCLS, FCLA, or similar). #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
    $54k-103k yearly Auto-Apply 18d ago
  • Part Time Private Investigator - Special Investigations Unit (SIU)

    The Robison Group 4.2company rating

    Investigator job in Atlanta, GA

    Are you looking for a company who believes in world class employee culture and focuses on growing YOU professionally? Alpine Intel is dedicated to innovation across the property, auto, liability, and workers comp insurance fields - helping our customers reach peak performance throughout the policy life cycle. Through our operating brands, HVACi, StrikeCheck, National Fire Experts, Donan Engineering, BSC Forensics, Component Testing Laboratories, The Robison Group, VRC Investigations, TechLoss, Mecanica Scientific Services, and HMI we are respected as the industry leader for our scale and our track record of conducting expert, specialized, and accurate investigations. Headquartered in Charlotte, North Carolina, our team of experienced professionals provides high-quality solutions nationwide. Alpine Intel is looking for bright candidates with a passion for problem solving to join our growing team. Welcome to Alpine Intel, a leader in the property insurance intelligence industry. We are currently seeking a Part Time Private Investigator - Special Investigations (SIU) to join our growing team in Atlanta, GA. Candidates with at least five (5) years of investigations experience are strongly encouraged to apply. Qualified candidates are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire damages, auto accidents, commercial claims, finding missing persons, courthouse searches, and other investigative tasks. As an SIU Investigator, you will be joining an incredible team of investigators and industry leaders. We are looking for people who are enthusiastic about investigations, those who thrive in a diverse work environment, and individuals who have a commitment to the very highest standards of honesty, integrity, and respect. Key Responsibilities Include: Complete recorded detailed interviews of those insured, claimants, witnesses, and others as identified. Complete scene investigations, including photographing. Conduct in-person visit of medical clinics. Complete neighborhood canvasses. Make sound judgments during the course of the investigation. Provide timely progress updates. Complete detailed investigative reports. Minimum Qualifications: MUST have current and active Private Investigation License to be eligible for hire. Self-motivated, determined, and intuitive with a strong initiative and work-ethic. Ability to identify critical issues quickly and accurately. Demonstrate observational, organizational, and listening skills. Excellent oral and written communication. Ability to work independently, as well as in a team. Flexible schedule working weekends, holidays, and possible evenings. Candidate must own a reliable computer, preferably a laptop, with access to high-speed internet and a scanner or fax machine. Must have strong computer and internet skills. Proficient with a digital camera. Must possess a valid driving license and own your reliable vehicle. Applicants must pass an extensive background check. Must be able to pass a drug test with negative results (except when undergoing documented medical treatment). College Degree preferred. To learn more about us visit ************************ Alpine Intel is committed to creating a diverse environment and is proud to be an equal opportunity employer. We are an E-Verify participating employer.
    $27k-41k yearly est. 50d ago
  • Healthcare Fraud Investigator

    Contact Government Services

    Investigator job in Atlanta, GA

    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 $85,000 - $105,000 a year 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.
    $30k-49k yearly est. 60d+ ago
  • Computer Forensics Investigator

    Xtreme Solutions

    Investigator job in Atlanta, GA

    Xtreme Solutions Inc. (XSI) is a rapidly expanding cybersecurity firm that provides innovative solutions to protect organizations from evolving cyber threats. We are seeking a highly skilled and certified Computer Forensics Investigator to join our cybersecurity team. The ideal candidate will possess extensive experience in digital evidence collection, analysis, and reporting to support investigations into cybercrimes, data breaches, and other security incidents. This role requires technical expertise, attention to detail, and the ability to maintain the integrity of evidence throughout investigations. Key Responsibilities Evidence Collection & Preservation Identify, collect, and preserve digital evidence in accordance with legal standards and best practices. Ensure chain-of-custody documentation is accurate and complete. Analysis & Investigation Analyze data from computers, mobile devices, networks, and other digital media for signs of malicious activity or unauthorized access. Recover and decrypt hidden, encrypted, or deleted files. Perform malware analysis and log reviews to trace the origins of attacks. Reporting & Documentation Prepare detailed forensic investigation reports, including findings, methodologies, and recommendations for remediation. Provide testimony as an expert witness during legal proceedings, if required. Collaboration Work closely with legal teams, law enforcement, and other stakeholders to support ongoing investigations. Partner with cybersecurity teams to identify and address vulnerabilities exploited in incidents. Tool Development & Maintenance Maintain and update forensic tools and software to ensure compatibility with evolving technologies. Recommend and implement new tools or techniques to enhance forensic capabilities. Work Environment Ability to handle confidential information with discretion and professionalism. Willingness to travel to onsite locations as needed for investigations. Availability to respond to incidents outside of standard business hours. Benefits and Compensation Competitive base salary with performance-based bonuses. Comprehensive health, dental, and vision insurance, with employer contributions. Generous 401(k) plan with company match. Flexible paid time off (PTO). Tuition reimbursement program to support your continuous learning and development. Opportunities for professional growth, with a potential pathway to leadership roles. Apply today to join a fast-growing cybersecurity firm committed to protecting organizations from the ever-evolving threat landscape. This position offers the opportunity to shape the future of cybersecurity with XSI. We value teamwork, integrity, professionalism, and innovation, and we look forward to welcoming the next member of our team! Send your resume and cover letter to [**************************].
    $29k-51k yearly est. Easy Apply 60d+ ago
  • Experienced Covert Surveillance Investigator - Part Time - Atlanta, GA

    Meridian Bank 4.6company rating

    Investigator job in Atlanta, GA

    JOB PURPOSE Conduct covert field surveillance with an emphasis on worker's compensation fraud and insurance fraud. DUTIES AND RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Conduct covert field surveillance via both stationary and mobile surveillance. Obtain professional quality video and photographic documentation of subjects. Prepare and file comprehensive investigative reports using the information that was collected from surveillance investigations. Upload video, photographs, audio files, and documents into the case management system. Conduct scene investigations, interviews, recorded statements, etc. Prepare written and recorded Statements from in-person interviews. Provide legal testimony. Other duties as assigned Requirements SKILLS AND QUALIFICATIONS Minimum two years experience working as an investigator. Ability to conduct covert field surveillance assignments. Ability to communicate effectively, both orally and in writing. Ability to gather data, compile information, and prepare reports. Ability to provide legal depositions and testimony. Ability to gather and organize evidence. Ability to investigate and analyze information. Knowledge of legal documentation procedures and requirements. LICENSES /CERTIFICATIONS REQUIREMENTS Valid state-issued driver's license. Current auto insurance. REQUIRED EQUIPMENT A reliable vehicle. Smartphone with access to the app store. Android OS7 or higher, Apple iOS 11 or higher. Laptop computer with Microsoft Word, Windows, and wireless Internet connection. Digital video camera with upload capability and accurate time and date stamp. Covert camera. WORKING CONDITIONS As an hourly, non-exempt status employee, your job may require extended work hours and significant work travel. This includes occasional overnight travel, weekend and/or evening work, and working on holidays. The worker is subject to inside environmental conditions: Protection from weather conditions but not necessarily from temperature changes. The worker is subject to outside environmental conditions: No effective protection from weather. The worker is subject to both environmental conditions: Activities occur inside and outside. PHYSICAL REQUIREMENTS The physical demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk and hear. The employee is frequently required to stand, walk, stoop, kneel, crouch, or crawl. The employee must regularly lift and/or move up to 10 pounds and frequently lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Work involves individuals to stay seated/sedentary for long periods of time. Work involves moderate exposure to unusual elements, such as extreme temperatures, exposure to the sun, and various days and hours of scheduled work. Salary Description Up to $30.00 per hour based on experience
    $30 hourly 60d+ ago
  • Surveillance Investigator - Metro Area

    Security Director In San Diego, California

    Investigator job in Atlanta, GA

    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. For a limited time only, we will cover the cost of Georgia's 70-hour prerequisite licensing course and provide paid training to help a few successful candidates break into the industry. Must possess a valid driver's license with at least one year of driving experience 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 2025-1505396
    $32k-48k yearly est. Auto-Apply 4d ago
  • Private Investigator - Company Vehicle Provided!

    Photofax 2.7company rating

    Investigator job in Atlanta, GA

    Surveillance Investigator PhotoFax, Inc., a nationwide private detective agency, is currently hiring surveillance investigators to join our team in the Atlanta region. If you like to work autonomously in dynamic environments, surveillance investigations provide an exciting career path meant just for you! Join the PhotoFax team today and we provide the tools necessary to start your career as a Private Investigator. What your day will look like: Monitoring, pursuing, and documenting individuals in a covert manner from a company issued-fully customized surveillance vehicle Pre and post surveillance briefing with your case manager to discuss objectives, surveillance tactics, and case details Detailed reporting on daily case observations Uploading video evidence obtained to the company database Frequent Regional Travel (in the company issued vehicle) Click to view our recruiting video! What you will gain: Experience that will lead to other opportunities in: Investigations Law enforcement Upper claims management Growth within PhotoFax A company issued vehicle customized for surveillance and all equipment necessary to do the job Hands on training with our experienced trainers with 34 years of investigative knowledge Full health benefits package including matching 401K Performance based reviews and bonuses Paid overtime and travel Cell phone reimbursement What you need to apply: High school diploma or GED Clean driving record with minimal infractions Must currently reside in the greater Atlanta area Flexibility to work any day of the week including weekends and holidays Willingness to travel with frequent overnight stays No previous experience is necessary; we provide all training and licensing
    $31k-48k yearly est. 60d+ ago
  • Healthcare Fraud Investigator

    Contact Government Services, LLC

    Investigator job in Atlanta, GA

    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
    $30k-49k yearly est. Auto-Apply 60d+ ago
  • Surveillance Investigator

    Frasco 4.1company rating

    Investigator job in Atlanta, GA

    Full-time Description Job Title: Surveillance Investigator Job Type: Full-Time, Billable Hours, Non-exempt Eager to start your career in a growing industry? Get paid to learn the ropes of fraud investigation and real-world surveillance. Frasco offers fully paid investigator training to help you launch your career! Is surveillance right for you? Watch this: **************************** Compensation: Hourly Rate: $20 - $26 per hour (Weekly Pay) Commensurate with experience and performance Travel Time: Travel commute time is compensated at 100% of regular hourly rate, after standard commute deduction Mileage Reimbursement: $0.50 per mile for all portal-to-portal and mobile surveillance mileage Paid Administrative Time: Paid at regular hourly rate (report writing, administrative time, etc.) Paid Training: Paid at regular hourly rate About Us: Frasco has been in business for 60 years as a family-owned full-service investigation company with hundreds of investigators and regional office nationwide. Our vibrant company culture, driven by core values of integrity, innovation, and excellence, fosters a supportive and collaborative environment where every individual is valued. We are committed to diversity and inclusion, encouraging applications from all backgrounds. Join us to make a meaningful impact and thrive in a positive, respectful workplace. Responsibilities: Review assignments to determine case objectives and develop or follow action plans Utilize various surveillance equipment and technology Perform surveillance and activity checks, documenting video footage and relevant information Conduct surveillance indoors and outdoors, involving extended periods of walking, standing, or sitting Drive safely and effectively in varied weather and traffic conditions Move swiftly and discreetly to observe subjects Maintain high standards of communication and confidentiality, adhering to ethical and legal guidelines Prepare detailed reports with timestamps and supporting evidence for legal use Adapt to changing circumstances and work flexible hours, including nights, weekends, and holidays Attend and testify at hearings as required Requirements Requirements: Exceptional writing and communication skills Strong attention to detail and commitment to accuracy and quality Ability to work independently and meet established deadlines Strong critical thinking skills Self-starter with accountability for results and performance Flexible schedule, including weekends Ability to travel to and from assignments daily Must obtain a Georgia investigator license Qualifications and Equipment: Valid driver's license with good driving record Minimum Auto Insurance Coverage: $100,000 per person, $300,000 per accident bodily injury, and $50,000 property damage Reliable personal vehicle, tinted windows preferred HD camcorder, covert camera, smartphone, computer or laptop, and internet connectivity Windows 11 or greater required, with 8+gb of RAM preferred Mac OSX 13 or greater required for iMac Preferred Experience: High school diploma or associate's degree in criminal justice or related field Military background; insurance or investigations experience Start your career with a leader in the investigations industry that is financially stable, is experiencing growth, and whose history spans over 60 years! Ready to make a difference? Apply now!All replies are confidential Equal Opportunity Employer PM18
    $20-26 hourly 44d ago

Learn more about investigator jobs

How much does an investigator earn in Duluth, GA?

The average investigator in Duluth, GA earns between $32,000 and $98,000 annually. This compares to the national average investigator range of $42,000 to $119,000.

Average investigator salary in Duluth, GA

$56,000

What are the biggest employers of Investigators in Duluth, GA?

The biggest employers of Investigators in Duluth, GA are:
  1. Omniplex World Services Corporation, A Constellis Company
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