Investigator jobs in South Charleston, WV - 171 jobs
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Special Investigation Unit Investigator
SIU Investigator III (Must live in MA or surrounding states)
Caresource 4.9
Investigator job in Dayton, OH
The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in provider billing behavior. Serves as a subject matter expert for other investigators. Qualified candidates must live in Massachusetts or surrounding states.
Essential Functions:
Develop, coordinate and conduct strategic fact-driven investigative projects including business process review, execution of investigative activities, and development of investigation outcome recommendations
Manage the development, production, and validation of reports generated from detailed claims, eligibility, pharmacy, and clinical data and translate analytical findings into actionable items
Manage strategic investigative plan and drive investigative outcome for the team
Ensure quality outcomes for investigative team through auditing and oversight
Prioritize, track, and report status of investigations
Report identified corporate financial impact issues
Use concepts and knowledge of coding guidelines to analyze complex provider claim submissions
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
Collaborate with data analytics team and utilize RAT STATS on Statistically Valid Random Sampling
Coordinate and conduct on-site and desk audits of medical record reviews and claim audits
Manage and decision claims pended for investigative purposes
Maintain a working knowledge of all state and federal laws, rules, and billing guidelines for various provider specialty types
Prepare and conduct in-depth complex interviews relevant to investigative plan
Execute and manage provider formal corrective action plans
Participate in meetings with operational departments, business partners, and regulatory partners to facilitate investigative case development
Participate in meetings with Legal General Counsel to drive case legal actions, formal corrective actions, negotiations with recovery efforts, settlement agreements, and preparation of evidentiary documents for litigation
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
SME in the designated market and ability to apply external intelligence to their analysis and case development
Develop and present internal and external formal presentations, as needed
Attend fraud, waste, and abuse training/conferences, as needed
Support regulatory fraud, waste, and abuse reports to federal and state Medicare/Medicaid agencies
Manage and maintain sensitive confidential investigative information
Maintain compliance with state and federal laws and regulations and contracts
Adhere to the CareSource Corporate Compliance Plan and the Anti-Fraud Plan
Assist in Federal and State regulatory audits, as needed
Perform any other job-related instructions, as requested
Education and Experience:
Bachelor's Degree or equivalent years of relevant work experience in Health-Related Field, Law Enforcement, or Insurance required
Master's Degree (e.g., criminal justice, public health, mathematics, statistics, health economics, nursing) preferred
Minimum of five (5) years of experience in healthcare fraud investigations, medical coding, pharmacy, medical research, auditing, data analytics or related field is required
Competencies, Knowledge and Skills:
Intermediate proficiency level in Microsoft Office to include Outlook, Word, Excel, Access, and PowerPoint
Effective listening and critical thinking skills and the ability to identify gaps in logic
Strong interpersonal skills, high level of professionalism, integrity and ethics in performance of all duties
Excellent problem solving and decision making skills with attention to details
Background in research and drawing conclusions
Ability to perform intermediate data analysis and to articulate understanding of findings
Ability to work under limited supervision with moderate latitude for initiative and independent judgment
Ability to manage demanding investigative case load
Ability to develop, prioritize and accomplish goals
Self-motivated, self-directed
Strong written skills with ability to compose detailed investigative reports and professional internal and external correspondences
Presentation experience, beneficial
Knowledge of Medicaid, Medicare, healthcare rules preferred
Background in medical terminology, CPT, HCPCS, ICD codes or medical billing preferred
Complex project management skills preferred
Display leadership qualities
Licensure and Certification:
One of the following certifications is required: Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE)
Certified Professional Coder (CPC) is preferred
NHCAA or other fraud and abuse investigation training is preferred
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Occasional travel (up to 10%) to attend meetings, training, and conferences may be required
Compensation Range:
$72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type:
Salary
Competencies:
- Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
#LI-SD1
$72.2k-115.5k yearly 6d ago
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SIU Investigator - Charleston, WV
Delta Group 3.8
Investigator job in Charleston, WV
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
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
SIU Investigator (mid-level) - P&C Multi-line (VA, WV or TN)
USAA 4.7
Investigator job in Charleston, WV
**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 and you must have multi-line experience, not just auto. 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. However, you must currently live in the covered territory, which is Virginia or West Virginia or Tennessee** **.** There may be occasional business travel.
**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:**
+ SIU experience conducting low to complex PNC 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:** The annualized range for this position is: $77,120 - $147,390. However, this is an hourly position.
**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._
**If you are an existing USAA employee, please use the internal career site in OneSource to apply.**
**Please do not type your first and last name in all caps.**
**_Find your purpose. Join our mission._**
USAA is unlike any other financial services organization. The mission of the association is to facilitate the financial security of its members, associates and their families through provision of a full range of highly competitive financial products and services; in so doing, USAA seeks to be the provider of choice for the military community. We do this by upholding the highest standards and ensuring that our corporate business activities and individual employee conduct reflect good judgment and common sense, and are consistent with our core values of service, loyalty, honesty and integrity.
USAA attributes its long-standing success to its most valuable resource: our 35,000 employees. They are the heart and soul of our member-service culture. When you join us, you'll become part of a thriving community committed to going above for those who have gone beyond: the men and women of the U.S. military, their associates and their families. In order to play a role on our team, you don't have to be connected to the military yourself - you just need to share our passion for serving our more than 13 million members.
USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.
California applicants, please review our HR CCPA - Notice at Collection (********************************************************************************************************** here.
USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.
$77.1k-147.4k yearly 43d ago
Contract Investigator - Charleston, WV
Omniplex World Services Corporation, A Constellis Company
Investigator job in Charleston, WV
OMNIPLEX World Services Corporation is seeking talented individuals committed to excellence, honesty, and integrity to join our team. We are a trusted provider of high quality background investigations programs to Department of Homeland Security (DHS) and the intelligence community at locations throughout the United States. OMNIPLEX is seeking to fill immediate and upcoming openings for Contract Investigators. A Contract Investigator works for us on an as needed basis and no hours are guaranteed. We prefer Contractors to be available to work a minimum of ten hours per week where work is available. Candidate must be willing to travel within a 35-50 mile radius from city location.
Candidate must be local to Charleston, WV
QUALIFICATIONS:
U.S. Citizenship;
H.S. Diploma or equivalent;
Minimum of 1 year of specialized Federal Background investigative experience within the last 5 years;
Must have some FIS Experience;
Reliable personal vehicle, valid driver's license, and satisfactory driving record;
Willing to travel on temporary duty assignments as needed (by car or plane);
Successfully pass background checks and all required training;
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists;
Ability to interpret a variety of instructions furnished in oral, written, diagram, or schedule form;
Ability to read, analyze, and interpret professional journals, technical procedures, or governmental regulations;
Ability to write reports and business correspondence;
Ability to work in a MS Window based operating environment, including proficiency with Microsoft Office (Word, Excel, PowerPoint), Internet and E-mail;
Current (within the last 2 years) Single Scope Background Investigation (SSBI) or active Secret level security clearance based on an SSBI and able to obtain the required security clearance.
Job Duties and Responsibilities:
Conduct in-person, one-on-one subject interviews to obtain factual information about the individual's background and character, in accordance with agency guidelines and instructions.
Obtain factual information from a variety of personal and record sources to produce a report of investigation that contains all pertinent facts of an individual's background and character in accordance with agency guidelines and instructions.
Travel throughout the geographic area of responsibility to conduct investigations at various places of employment, residence, and education institutions as cases are assigned.
Must be willing to travel in and around assigned location within 30-50 miles (or more) as needed
Engage in dialogue on a regular basis with managers and representatives at contractor facilities, various U. S. Government organizations, and law enforcement agencies to develop and maintain effective and cooperative working relationships.
Adapt to changing situations and environments as they occur and be able to interact with people from all walks of life and socioeconomic levels.
Demonstrate strong verbal and written communications skills and exhibit professional demeanor in all situations.
Work load based on availability of cases in geographic area.
Some voluntary, temporary duty assignments in other areas of the country (typically 2-4 weeks at a time) are possible.
Other duties as required.
Desired Experience and Education:
Background Investigator Training that meets the National Training Standards (NTS)
Prior background investigations experience supporting government contracts.
Associate or Bachelor degree in Criminal Justice or a related field.
Current Top Secret clearance
WORKING CONDITIONS:
Work is typically based in the investigator's home office as well as in the investigator's personal vehicle traveling to various field locations to conduct interviews. Coverage area varies and could include some extended drives. Work hours vary depending on availability of leads and do not always fall within normal business hours, to include potential weekend hours or third-shift appointments.
PHYSICAL REQUIREMENTS:
Requires intermittent standing, writing/typing, walking, sitting, and driving throughout the workday, and may include for multiple hours.
rs
$48k-86k yearly est. 60d+ ago
Senior Investigator (Aetna SIU)
CVS Health 4.6
Investigator job in Charleston, WV
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
WEST VIRGINIA RESIDENCY REQUIRED
As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex cases involving multi-lines of business, or cases involving multiple perpetrators or intricate healthcare fraud schemes.
Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business
Researches and prepares cases for clinical and legal review
Documents all appropriate case activity in case tracking system
Facilitates feedback with providers related to clinical findings
Initiates proactive data mining to identify aberrant billing patterns
Makes referrals, both internal and external, in the required timeframe
Facilitates the recovery of company and customer money lost as a result of fraud matters
Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators.
Assists Investigators in identifying resources and best course of action on investigations
Serves as back up to the Team Leader as necessary
Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters.
Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings
Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach to fighting fraud
Provides input regarding controls for monitoring fraud related issues within the business units
Required Qualifications
WEST VIRGINIA RESIDENCY REQUIRED
3-5 years investigative experience in the area of healthcare fraud and abuse matters.
Working knowledge of medical coding; CPT, HCPCS, ICD10
Proficiency in Microsoft Office with advanced skills in Excel (must know how to do pivot tables).
Strong analytical and research skills.
Proficient in researching information and identifying information resources.
Strong verbal and written communication skills.
Ability to travel up to 10% (approx. 2-3x per year, depending on business needs)
Preferred Qualifications
Previous Medicaid/Medicare investigatory experience
Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations for fraud and abuse.
Credentials such as certification from the Association of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti-Fraud Association (AHFI)
Knowledge of Aetna's policies and procedures.
Knowledge and understanding of complex clinical issues.
Competent with legal theories.
Strong communication and customer service skills.
Ability to effectively interact with different groups of people at different levels in any situation.
Education:
Bachelor's degree or equivalent experience (3-5 years of working health care fraud, waste and abuse investigations).
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$46,988.00 - $102,000.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 02/10/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$47k-102k yearly Auto-Apply 60d+ ago
Private Investigator - Company Vehicle Provided!
Photofax 2.7
Investigator job in Cleveland, OH
PhotoFax, Inc., a nationwide private detective agency, is currently hiring surveillance investigators to join our team in the Cleveland, OH region.
If you like to work autonomously in dynamic environments, surveillance investigations provide an exciting career path meant just for you! Join the PhotoFax team today and we provide the tools necessary to start your career as a Private Investigator.
What your day will look like:
Monitoring, pursuing, and documenting individuals in a covert manner from a company issued-fully customized surveillance vehicle
Pre and post surveillance briefing with your case manager to discuss objectives, surveillance tactics, and case details
Detailed reporting on daily case observations
Uploading video evidence obtained to the company database
Occasional Regional Travel (in the company issued vehicle)
View our recruiting video: https://vimeo.com/323***********b7a16e
What you will gain:
Experience that will lead to other opportunities in:
Investigations
Law enforcement
Upper claims management
Growth within PhotoFax
A company issued vehicle customized for surveillance and all equipment necessary to do the job
Hands on training with our experienced trainers with 34 years of investigative knowledge
Full health benefits package including matching 401K
Performance based reviews and bonuses
Paid overtime and travel
What you need to apply:
High school diploma
Associates/Bachelor's degree in Criminal Justice/Criminology/Law Enforcement preferred
Valid driver's license
Clean driving record with minimal infractions
Must currently reside in the greater Cleveland area
Flexibility to work any day of the week including weekends and holidays
Willingness to travel with occasional overnight stays
No previous experience is necessary; we provide all training and licensing
$37k-60k yearly est. 60d+ ago
Investigator Senior
Carebridge 3.8
Investigator job in Charleston, WV
Supports the Payment Integrity line of business Hybrid 1: 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. Alternate locations may be considered.
* Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.
The Investigator Senior is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims. Health insurance experience required with understanding of health insurance policies, health insurance claims handling and provider network contracting.
How will you make an impact:
* 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.
* Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one company health plan, line of business and/or state.
* 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.
* May be called upon to represent the Company in court proceedings regarding research findings.
* Develops and maintains a high degree of rapport and cooperation with the Federal, State and local law enforcement and regulatory agencies which can assist in investigative efforts.
Minimum Requirements
* Requires a BA/BS and minimum of 5 years related experience in healthcare insurance and healthcare insurance investigation, law enforcement; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications, Skills & Capabilities
* Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job related designation preferred.
* Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $78,400 to $141,120.
Locations: California, Colorado, District of Columbia (Washington, DC), Maryland, Minnesota, New York, Washington State
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
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.
$41k-73k yearly est. Auto-Apply 60d+ ago
SIU Investigator - Underwriting & Premium Fraud
CNA Financial Corp 4.6
Investigator job in Louisville, KY
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 35d ago
Part-Time Surveillance Investigator
The Robison Group 4.2
Investigator job in Charleston, WV
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.
Individuals selected for the position will be expected to perform investigations of workers compensation claims, liability investigations, multi-line insurance claims, criminal and civil background checks, and other investigative tasks.
The majority of cases worked in this position require stationary and mobile video surveillance.
PRINCIPAL RESPONSIBILITIES FOR SURVEILLANCE:
Thoroughly complete assigned cases.
Testify to the collected facts obtained in any hearing or court of law as needed.
Assist other investigators on challenging cases.
Make sound judgments both during the investigation and with future handling recommendations.
Turn in updates, evidence, and report in timely manner.
Upload surveillance video upon completion of investigation.
The nature of this job requires early hours, long days, and travel into surrounding areas.
WHO SHOULD APPLY:
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.
Candidates with at least one year of PI experience are strongly encouraged to apply.
POSITION QUALIFICATIONS:
Self-motivated, determined, and intuitive.
Strong initiative and work ethic.
Ability to identify critical issues quickly and accurately
Demonstrated 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.
Access to high-speed internet and a scanner or fax machine.
Must have strong computer and internet skills.
Proficient with a digital camera.
Must own reliable transportation.
Possess a valid driving license.
Upon hire, candidate will be asked to submit a driving record provided by the state DMV or Secretary of State.
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.
TRAINING
The Robison Group provides remote and/or in-classroom training to ensure that individuals are set up for success before moving into their roles.
COMPENSATION & REIMBURSEMENTS:
Paid travel time and reimbursement for mileage, tolls, and other per diem items.
Hourly Rate is commensurate with education and experience.
OPPORTUNITIES FOR GROWTH WITHIN THE COMPANY INCLUDE:
SIU work, Field Supervisor, Field Operations Manager, Case Management, etc.
$32k-45k yearly est. 52d ago
Private Investigator
Advantage Surveillance LLC 3.6
Investigator job in Bowling Green, KY
Job Description
For the past 28 years, Advantage Investigations has been the Nation's only insurance defense investigation firm that invests in the operational capabilities necessary to produce consistent, high-quality results-ultimately helping our clients "See What's True."
With over 200+ licensed private investigators Nationwide, Advantage uses strategic planning and technology to give our clients greater clarity on a claimant's daily activities. Providing Covert Surveillance, Claims Investigations, Net-Sweep Investigations, Remote Controlled Surveillance, and more, we're able to save our clients time and money on insurance fraud cases.
Advantage Investigations is seeking a Full Time Private Investigator in the Bowling Green, KY & surrounding areas. The qualified candidate will be responsible for conducting covert surveillance, investigating daily activities, obtaining video evidence, and providing a clear report of all activities for our operations team along with basic claims investigations. As a private investigator, you will be provided with a comprehensive training program, door to door pay, fuel card, vehicle and phone allowance, top-of-the-line equipment, as well as other generous benefits. This position requires daily travel within the investigator's area/territory.
** Current KY Private Investigator License preferred **
Duties & Responsibilities:
Conducting surveillance including covert, stationery, and mobile
Conducting surveillance throughout their home state and surrounding states
Recording subject activity on a video recording device
Conducting alive and well checks, locates, basic scene investigations, paint sample analysis, EDR, and RCS deployments/retrievals
Preparing and completing a written report of observations
Uploading Video Evidence and a surveillance report
Qualifications & Requirements:
Current KY Private Investigator License preferred
Private Investigator Licenses required - Licensing differs between states
Previous experience related to surveillance/claims investigations is preferred
Access to a reliable, suitable surveillance vehicle for day-to-day use
Valid Driver's License
Ability to provide MVR (driving record)
Willingness to travel throughout home state and surrounding states for work
Varying weekly work schedule includes weekend and holiday availability
Good oral and written communication skills
Self-motivated, ability to work independently
Meet state mandated requirements to obtain and maintain a Private Investigator license multiple states
Must pass a Drug Screen
Compensation:
Investigators are paid door to door at an hourly rate commensurate with experience, within $21.00 to $25.00 an hour. Employees are paid on a bi-weekly basis.
Company Benefits:
Door to Door hourly pay
Fuel Card provided
Monthly Vehicle Allowance
Monthly Cell Phone Allowance
Equipment Provided
Medical, Dental, Vision, and Disability insurance
Life Insurance and other supplemental options
Paid Lodging (when applicable), and per diem pay when out of town
401(k) - with match
2 weeks of PTO (paid time off)
Parental Leave
Advantage Investigations is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
#ZR
$21-25 hourly 2d ago
Fraud Investigator
Insight Global
Investigator job in Blue Ash, OH
An employer in the Blue Ash/Cincinnati, Ohio area is seeking a detail-oriented and analytical Fraud Investigator to join it's retail grocery Asset Protection team. This role is critical in identifying and mitigating internal fraud and shrink through data analysis and investigative techniques. The ideal candidate will have experience in fraud detection, auditing, or compliance, and a strong ability to interpret complex data sets to uncover patterns of nefarious activity. Using data from the MAX Asset Protection system, the Fraud Investigator will identify suspicious patterns and investigate potential internal fraud. This includes uncovering schemes such as credit card theft, coupon and gift card abuse, and internal shrink related to inventory discrepancies.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: ****************************************************
Skills and Requirements
- Experience in fraud investigation, auditing, compliance, or data analysis.
- Strong analytical skills and attention to detail, with the ability to interpret complex data sets.
- Proficiency in Excel and data visualization tools.
- Excellent written and verbal communication skills, including the ability to document findings clearly and professionally. - Experience with investigative or case management software
- Retail experience
- Familiarity with retail operations or asset protection systems
$41k-65k yearly est. 7d ago
Field Investigator (Public Utilities Gas Pipeline Safety Compliance Investigator)
Dasstateoh
Investigator job in Ohio
Field Investigator (Public Utilities Gas Pipeline Safety Compliance Investigator) (260000AF) Organization: Public Utilities CommissionAgency Contact Name and Information: HUMAN RESOURCES - ContactJobsHR@puco.ohio.gov.Unposting Date: Feb 16, 2026, 8:59:00 PMPrimary Location: United States of America-OHIO-Marion CountyOther Locations: United States of America-OHIO-Crawford County, United States of America-OHIO-Morrow County, United States of America-OHIO-Richland County Compensation: 33.52Schedule: Full-time Work Hours: 7:30-3:30 Flex AvailableClassified Indicator: ClassifiedUnion: OCSEA Primary Job Skill: UtilitiesTechnical Skills: Inspection Principles, Auditing, Investigation, Compliance EnforcementProfessional Skills: Attention to Detail, Observation Agency Overview The Public Utilities Commissions of Ohio (PUCO) affect nearly every household in Ohio. The PUCO regulates providers of all types of utility services which include electric and natural gas companies, local and long-distance telephone, water and wastewater, and rail and trucking companies. More recently, the PUCO gained responsibility for facilitating competitive utility choices for Ohio consumers.To carry out our responsibilities, the PUCO employs a professional staff that includes engineers, economists, attorneys, and safety inspectors. Continually monitoring the activities of utility and transportation companies, the PUCO works to ensure safe and reliable services for all Ohioans.Our mission is to assure all residential and business consumers access to adequate, safe and reliable utility services at fair prices, while facilitating an environment that provides competitive choices.Job DutiesField Investigator (Public Utilities Gas Pipeline Safety Compliance Investigator) Service Monitoring & Enforcement Department (SMED) Facility and Operations Field Division (FOFD) Hourly Rate: $33.52 About The Service Monitoring & Enforcement Department:The Service Monitoring and Enforcement Department's (SMED) mission is to enforce consumer safeguards, to resolve consumer complaints and to ensure Ohio utility consumers receive safe and reliable services. SMED is organized into three divisions.Facility Operations Field Division (FOFD) Facility Operations Field Division (FOFD) staff regularly inspects utility facilities and reviews plant operating practices to ensure regulated utility service providers deliver safe, reliable and quality service. Field investigators from the division's electric, telephone, water/wastewater and gas pipeline safety sections perform on-site inspections and audit company records to ensure utilities observe regulatory requirements. FOFD staff also participates in rate case proceedings and recommends changes in company policies and practices to improve utility service. FOFD staff also acts as the agency lead for the damage prevention complaint reporting and tracking process; assisting with the maintenance of the damage prevention enforcement database; and answering internal and public inquiries. What You'll Do:The Gas Pipeline Safety team at the PUCO is responsible for enforcing federal and state pipeline safety regulations. We work in partnership with the federal Pipeline and Hazardous Materials Safety Administration (PHMSA).In this position as a Gas Pipeline Safety Compliance Investigator, you will be a field-based employee responsible for scheduling, coordinating, and conducting independent field audits and inspections with gas utilities. Inspections include:Reviews of company plans and procedures Reviews of company construction, operations, and maintenance records Field observations of gas company employees and contractors Field inspections of company pipeline facilities.You will also be assigned to investigate natural gas related incidents and complaints.The position will involve learning and applying federal and state pipeline safety regulations to various company records and facilities to determine whether the company is complying with the regulations. Some inspections are performed as part of a team, but most inspections are performed independently.This position will be based in North Central Ohio and most assignments will be in that part of the state but occasional assignments requiring overnight stays in other parts of the state are possible. Travel to Columbus will also be required throughout the year for meetings at the PUCO headquarters in downtown Columbus. The position will also require the successful completion of several training courses at PHMSA's training facility in Oklahoma City, OK during the first 3 years in the position. A state vehicle will be assigned for work related travel within the state. The selected candidate must reside in or relocate to Marion, Morrow, Crawford, or Richland County areas. Please make sure the duty section of your work history clearly demonstrates 5 years of natural gas related experience to meet minimum qualifications. We will not be able to review any resumes or other attachments. Salary Information: Unless required by legislation or union contract, starting salary is set at the lowest rate of the salary range. In most cases, successful employees will increase a step in the salary range within six months, with subsequent step increases occurring every year. In addition, the State of Ohio offers cost of living adjustments, longevity supplements after five years of public service, and wellness incentives. Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:
Medical Coverage
Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
Childbirth, Adoption, and Foster Care leave
Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.Qualifications5 yrs. exp. in construction & operation of natural gas pipeline systems; 1 course or 3 mos. trg. in general management; 3 mos. trg. or 3 mos. exp. in public relations; valid driver's license. -Or 5 yrs. exp. as gas pipeline safety inspector & successful completion of seven basic gas pipeline safety courses from Transportation Safety Institute; valid driver's license. -Or completion of undergraduate core program in mechanical, electrical or civil engineering; valid driver's license. -Or completion of undergraduate core program in mechanical, electrical or civil engineering technology; 3 yrs. exp. in construction & operation of natural gas pipeline systems; successful completion of seven basic Transportation Safety Institute courses in gas pipeline safety; valid driver's license. -Or completion of undergraduate core program in mechanical, electrical or civil engineering technology; 3 yrs. exp. as gas pipeline safety inspector; completion of seven basic gas pipeline safety courses from Transportation Safety Institute; valid driver's license. -Or equivalent of Minimum Class Qualifications for Employment noted above. Job Skills: UtilitiesSupplemental InformationApplications must clearly indicate how the applicant meets the minimum qualifications for the position. All answers to the supplemental questions must be supported by information provided in the work experience and/or education sections on your civil service application. If you don't demonstrate how, you meet minimum qualifications in the supplemental questions, your application may be disqualified from consideration. Please do not use "see resume or other documents" as assumptions will not be made. Selection devices, proficiency testing, and/or assessments may be used to determine if an applicant meets and is proficient in the minimum qualifications for this position. If you are applying for the same classification within a six-month period, your previous score from the selection instrument (interview, proficiency test, and/or assessment) may be carried forward for consideration. ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.
$33.5 hourly Auto-Apply 15h ago
Special Investigations Unit (SIU) - Field Investigator
Ethos Risk Services
Investigator job in Dayton, OH
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.
$33k-53k yearly est. 35d ago
As Needed Field Investigator- Dayton, OH
J T Becker & Co
Investigator job in Dayton, OH
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
$27k-40k yearly est. 60d+ ago
Field Investigator/Camera Car Driver/Spotter
Interlink Recovery Services
Investigator job in Euclid, OH
Field Investigator / Camera Car Driver / Spotter Euclide OH Schedule: Monday - Friday / 4a.m-12p.m Sunday - Thursday / 7p.m - 3a.m InterLink is seeking a dependable and motivated Camera Car Driver/Repossession Field Investigator to join our team! This role is responsible for identifying and locating vehicles that are out for repossession. This position is
crucial to our company and we are looking for the best in the industry! Vehicle equipped with an iPad and license plate recognition system provided.
We offer a full benefits package to full-time employees and a competitive base wage plus commission! Room for growth!!!
$15/hr + commission for each vehicle that is spotted and secured.
Camera Car Driver - Spotter/Repossession Field Investigator Responsibilities:
Drive for 8 hours/shift in designated zone to attempt to locate vehicles at specific addresses
Identify and take photos of vehicles
Collect license plate data and verify vehicle identification numbers (VIN)
Report vehicle location and data to InterLink team
Pick-up and drop off company vehicle before and after shift
Assisting agents with acceptance of assignments during non-office hours
Camera Car Driver/Spotter - Repossession Field Investigator Requirements:
Valid driver's license with clean driving record
Be able to pass a criminal background check/no felonies
Be able to pass a drug screen
Basic computer skills
Attention to detail
Sense of urgency and self motivated/able to work on your own
Ability to pass a required certification course
Prior experience in a driving profession desired: cab driver, delivery drivers of any kind
Benefits for full-time employees:
Competitive compensation
Health insurance
Paid time off
Paid training
Opportunities for career growth and development
$15 hourly Auto-Apply 31d ago
Surveillance Investigator
Security Director In San Diego, California
Investigator job in Huntington, WV
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.
No office to go to - travel daily to cases in the field!
Company credit card to cover fuel and hotel expenses
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 2026-1518434
$29k-43k yearly est. Auto-Apply 1d ago
Private Investigator - Company Vehicle Provided!
Photofax 2.7
Investigator job in Cleveland, OH
Job DescriptionSalary: $20-$25
Private Investigator - Company Vehicle Provided!
PhotoFax, Inc., a nationwide private detective agency, is currently hiring surveillance investigators to join our team in the Cleveland, OH region.
If you like to work autonomously in dynamic environments, surveillance investigations provide an exciting career path meant just for you! Join the PhotoFax team today and we provide the tools necessary to start your career as a Private Investigator.
What your day will look like:
Monitoring, pursuing, and documenting individuals in a covert manner from a company issued-fully customized surveillance vehicle
Pre and post surveillance briefing with your case manager to discuss objectives, surveillance tactics, and case details
Detailed reporting on daily case observations
Uploading video evidence obtained to the company database
Occasional Regional Travel (in the company issued vehicle)
View our recruiting video: https://vimeo.com/323***********b7a16e
What you will gain:
Experience that will lead to other opportunities in:
Investigations
Law enforcement
Upper claims management
Growth within PhotoFax
A company issued vehicle customized for surveillance and all equipment necessary to do the job
Hands on training with our experienced trainers with 34 years of investigative knowledge
Full health benefits package including matching 401K
Performance based reviews and bonuses
Paid overtime and travel
What you need to apply:
High school diploma
Associates/Bachelor's degree in Criminal Justice/Criminology/Law Enforcement preferred
Valid driver's license
Clean driving record with minimal infractions
Must currently reside in the greater Cleveland area
Flexibility to work any day of the week including weekends and holidays
Willingness to travel with occasional overnight stays
No previous experience is necessary; we provide all training and licensing
$20-25 hourly 4d ago
Special Investigations Unit (SIU) - Field Investigator
Ethos Risk Services
Investigator job in Dayton, OH
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
$33k-53k yearly est. 5d ago
Field Investigator/Camera Car Driver/Spotter
Interlink Recovery Services LLC
Investigator job in Euclid, OH
Job DescriptionField Investigator / Camera Car Driver / Spotter Euclide OH Schedule: Monday - Friday / 4a.m-12p.m Sunday - Thursday / 7p.m - 3a.m InterLink is seeking a dependable and motivated Camera Car Driver/Repossession Field Investigator to join our
team! This role is responsible for identifying and locating vehicles that are out for repossession. This position is
crucial to our company and we are looking for the best in the industry! Vehicle equipped with an iPad and license plate recognition system provided.
We offer a full benefits package to full-time employees and a competitive base wage plus commission! Room for growth!!!
$15/hr + commission for each vehicle that is spotted and secured.
Camera Car Driver - Spotter/Repossession Field Investigator Responsibilities:
Drive for 8 hours/shift in designated zone to attempt to locate vehicles at specific addresses
Identify and take photos of vehicles
Collect license plate data and verify vehicle identification numbers (VIN)
Report vehicle location and data to InterLink team
Pick-up and drop off company vehicle before and after shift
Assisting agents with acceptance of assignments during non-office hours
Camera Car Driver/Spotter - Repossession Field Investigator Requirements:
Valid driver's license with clean driving record
Be able to pass a criminal background check/no felonies
Be able to pass a drug screen
Basic computer skills
Attention to detail
Sense of urgency and self motivated/able to work on your own
Ability to pass a required certification course
Prior experience in a driving profession desired: cab driver, delivery drivers of any kind
Benefits for full-time employees:
Competitive compensation
Health insurance
Paid time off
Paid training
Opportunities for career growth and development
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$15 hourly 2d ago
As Needed Field Investigator- Louisville, KY
J T Becker & Co
Investigator job in Kentucky
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
How much does an investigator earn in South Charleston, WV?
The average investigator in South Charleston, WV earns between $36,000 and $112,000 annually. This compares to the national average investigator range of $42,000 to $119,000.
Average investigator salary in South Charleston, WV
$64,000
What are the biggest employers of Investigators in South Charleston, WV?
The biggest employers of Investigators in South Charleston, WV are: