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Become A Senior Investigator

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Working As A Senior Investigator

  • Getting Information
  • Identifying Objects, Actions, and Events
  • Documenting/Recording Information
  • Interacting With Computers
  • Making Decisions and Solving Problems
  • Mostly Sitting

  • Make Decisions

  • Stressful

  • $56,690

    Average Salary

What Does A Senior Investigator Do At Unitedhealth Group

* Under the direction of the SIU Manager, the Senior Investigator will: Verify the validity of all pharmacy credentialing applications associated with a pharmacy by means of conducting internal and external searches, internet research and unannounced pharmacy inspections.
* Perform background checks on employees/entities as well as further analytics to identify past/present association(s) with pharmacies terminated from the Pharmacy Network and/or engagement in FWA activity.
* Validate purchase invoices, and/or other applicable documentation, as well as correlating billing records.
* Execute unannounced pharmacy inspections to ensure compliance with state and/or federal regulations, codes and statutes.
* Verify current on-hand inventory and acquire a complete listing of wholesaler(s).
* Obtain and analyze claims billing and payment data as necessary.
* Interview witnesses who have knowledge of alleged fraud/abuse activity.
* Maintain accurate, current and thorough case information in the SIU case tracking database Gather and document objective evidence and recommend credentialing/contracting of pharmacies based on the investigative findings.
* Secure documentation and prepare summaries of the findings.
* Control and maintain Company and departmental data to ensure confidentiality in accordance with Company policy.
* Report suspected FWA to appropriate federal or state government regulators.
* Testify in criminal, civil and/or administrative proceedings as required.
* Attend continuing anti-fraud training

What Does A Senior Investigator Do At Commonwealth Care Alliance

* Triage assigned leads and make determinations on opening cases for investigations.
* Investigations process may include research, data analysis, process analysis, interviews, follow-up and maintaining complete documentation.
* Maintain detailed case files and accurately summarize investigative findings and conclusions.
* Write investigative summary reports detailing case findings and recommendations.
* Maintain complete and accurate documentation of all correspondence, including telephone, spoken and written conversations, and actions taken on each case investigation.
* Conduct research on providers using available and industry-standard resources for case development.
* Use appropriate resources (state or board websites) to verify provider licensure and check for sanctions.
* Exercise sound, independent decision making.
* Carefully analyze factual findings in order to determine proper case disposition and follow up.
* Identify and request reports from the Business Intelligence team.
* Have ability to work with Business Intelligence Team to provide data in format required for investigations.
* Actively promotes a team environment.
* Regularly interact with colleagues in various departments across the organization to conduct investigations and implement corrective action where necessary.
* Recommend algorithms and code edits for investigations.
* Secondary Responsibilities:
* Identify and recommend enhancements to systems and processes.
* Assist or lead special projects related to the investigative function, as necessary.
* Provide regular written and verbal updates to management.
* Adherence to HIPAA privacy and security requirements.
* Assist or lead special projects related to the investigative function, as necessary.
* Work closely with the investigative assistant role to prioritize and manage workload and provide direction

What Does A Senior Investigator Do At E*Trade Financial

* This position reports directly to the Director/Senior Manager, Investigations.
* The Senior Investigator researches, investigates and reports on incidents of fraud, loss, theft and employee misconduct.
* Additional duties include conducting both internal and external investigations, due diligence and background investigations and recovering or placing a claim on assets lost as a result of fraud.
* Investigates and documents cases of known or suspected fraud, loss, theft and employee misconduct covering all lines of business for the Firm and its entities.
* Recovers on all financial loss (including theft of property) for the Firm by placing claims on assets, filing criminal charges and/or working with the Legal Department on civil issues.
* Coordinates with law enforcement on criminal matters.
* Conducts public records searches and E
* TRADE database searches to compile information for investigations.
* Completes Suspicious Activity Reports (SARs) for all fraud, loss and internal investigations.
* Identifies risk and suggests solutions to help mitigate loss.
* Assists with the development, implementation, and training of fraud detection/prevention systems.
* Coordinates investigative activities with Legal, Compliance and other business units.
* Maintains data pertaining to risks identified, fraud management and recoveries.
* Assists with projects and preparing reports that communicate trends, losses, recoveries and investigation results to senior management

What Does A Senior Investigator Do At Idaho Division of Human Resources

* Conduct inspections, both announced and unannounced, of certified organic crop, livestock and processing operations.
* Conduct investigations of certified organic operations in the event complaints are filed.
* Inspections and investigations involve considerable report writing, documenting statements, photographing, collecting evidence, and compiling case data.
* All reports must be prepared in a timely manner and accurate to withstand legal scrutiny.
* Evaluate organic crop, livestock, and processing organic system plans for compliance with the National Organic Program standards.
* Evaluate materials and labels to determine compliance with organic standards.
* Participate in the development of program documents and procedures.
* Extended work days, overnight stays, and extensive travel between various work sites is required.
* Communicate comfortably and effectively both verbally and in writing with a large number of diverse clients.
* Must be comfortable with having difficult conversations and conveying complex and sometimes unfavorable information

What Does A Senior Investigator Do At L.A. Care Health Plan

* Position will perform in-depth evaluation of potential fraud & abuse cases and develops complex investigations that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for fraud & abuse.
* In addition, this role will be responsible for building the investigative approach and provide leadership for Investigators through mentoring, on-site audit leadership, and hands-on training of investigative techniques.
* Responsible for in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, and member across products at L
* A. Care Health Plan.
* Ensures adherence to L
* A. Care Health Plan policies and procedures for its various product offerings.
* Conducts investigation-related training

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How To Become A Senior Investigator

Private detectives and investigators typically need several years of work experience in law enforcement or the military. Workers must also have a high school diploma, and the vast majority of states require private detectives and investigators to have a license.

Education

Education requirements vary greatly with the job, but most jobs require a high school diploma. Some, though, may require a 2- or 4-year degree in a field such as criminal justice or police science. 

Corporate investigators typically need a bachelor’s degree. Often, coursework in finance, accounting, and business is preferred. Because many financial investigators have an accounting background, they typically have a bachelor’s degree in accounting or a related field and may be certified public accountants (CPAs). 

Computer forensics investigators often need a bachelor’s degree in computer science or criminal justice. Some colleges and universities now offer certificate programs in computer forensics, and others offer a bachelor’s or a master’s degree.

Training

Most private detectives and investigators learn through on-the-job experience, often lasting several years.

Although new investigators must learn how to gather information, additional training depends on the type of firm that hires them. For instance, at an insurance company, a new investigator will learn on the job how to recognize insurance fraud. Corporate investigators hired by large companies may receive formal training in business practices, management structure, and various finance-related topics. 

Because computer forensics specialists need to both use computers and possess investigative skills, extensive training may be required. Many learn their trade while working for a law enforcement agency for several years. At work, they are taught how to gather evidence and spot computer-related crimes.

Continuing education is important for computer forensics investigators because they work with changing technologies. Investigators must learn the latest methods of fraud detection and new software programs. Many accomplish this task by attending conferences and courses offered by software vendors and professional associations.

Work Experience in a Related Occupation

Private detectives and investigators typically must have previous work experience, usually in law enforcement, the military, or federal intelligence. Those in such jobs, who are frequently able to retire after 20 or 25 years of service, may become private detectives or investigators in a second career.

Other private detectives and investigators previously may have worked for insurance or collections companies, as paralegals, in finance, or in accounting.

Licenses, Certifications, and Registrations

The vast majority of states require private detectives and investigators to have a license. Requirements vary with the state. Professional Investigator Magazine has links to each state’s licensing requirements. Because laws often change, jobseekers should verify the licensing laws related to private investigators with the state and locality in which they want to work.

In most states, detectives and investigators who carry handguns must meet additional requirements.

Although there are no licenses specific to computer forensics investigators, some states require them to be licensed private investigators. Even in states and localities where they are not required to be licensed, having a private investigator license is useful because it allows computer forensics investigators to perform related investigative work. 

Candidates may also obtain certification, although it is not required for employment. Still, becoming certified through professional organizations can demonstrate competence and may help candidates advance in their careers.

For investigators who specialize in negligence or criminal defense investigation, the National Association of Legal Investigators offers the Certified Legal Investigator certification. For investigators who specialize in security, ASIS International offers the Professional Certified Investigator certification.

Important Qualities

Communication skills. Private detectives and investigators must listen carefully and ask appropriate questions when interviewing a person of interest.

Decisionmaking skills. Private detectives and investigators must be able to think on their feet and make quick decisions, based on the limited information that they have at a given time.

Inquisitiveness. Private detectives and investigators must want to ask questions and search for the truth.

Patience. Private detectives and investigators may have to spend long periods conducting surveillance while waiting for an event to occur. Investigations may take a long time, and they may not provide a resolution quickly—or at all.

Resourcefulness. Private detectives and investigators must work persistently with whatever leads they have, no matter how limited, to determine the next step toward their goal. They sometimes need to anticipate what a person of interest will do next.

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Senior Investigator jobs

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Senior Investigator Career Paths

Senior Investigator
Compliance Officer Safety Manager Human Resources Manager
Assistant Vice President
7 Yearsyrs
District Manager Operations Manager
Branch Manager
6 Yearsyrs
Team Leader Team Manager Unit Manager
Collections Manager
5 Yearsyrs
Assistant Vice President Human Resources Coordinator
Director Of Human Resources
10 Yearsyrs
Team Leader Security Officer Loss Prevention Manager
District Loss Prevention Manager
7 Yearsyrs
Senior Analyst Senior Finance Analyst
Finance Manager
7 Yearsyrs
Manager Correction Officer Loss Prevention Officer
Loss Prevention/Safety Manager
7 Yearsyrs
President President & Chief Operating Officer Executive Assistant/Office Manager
Manager Executive
6 Yearsyrs
Operations Manager Account Executive Assistant Vice President
Manager, Assistant Vice President
7 Yearsyrs
Chief Investigator Chief Deputy Chief Of Staff
Medical Director
9 Yearsyrs
Program Manager General Manager
Operations Director
9 Yearsyrs
Security Officer Service Technician Service Manager
Operations Manager
7 Yearsyrs
Program Manager Operations Director
President Of Operations
11 Yearsyrs
Security Officer Technician Project Manager
Program Manager
8 Yearsyrs
Chief Investigator Security Officer Operations Manager
Purchasing Manager
9 Yearsyrs
Compliance Officer Compliance Manager Senior Manager
Regional Director
9 Yearsyrs
Assistant Vice President Project Manager General Manager
Regional Manager
8 Yearsyrs
District Manager Regional Manager Operations Manager
Regional Operation Manager
9 Yearsyrs
Senior Analyst Project Manager Program Manager
Senior Manager
10 Yearsyrs
Operations Manager Branch Manager Assistant Vice President
Vice President And Manager
10 Yearsyrs
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Senior Investigator Demographics

Gender

  • Male

    64.0%
  • Female

    33.2%
  • Unknown

    2.8%

Ethnicity

  • White

    77.2%
  • Hispanic or Latino

    12.9%
  • Asian

    7.5%
  • Unknown

    1.9%
  • Black or African American

    0.6%
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Languages Spoken

  • Spanish

    71.4%
  • French

    10.7%
  • German

    3.6%
  • Russian

    3.6%
  • Indonesian

    1.8%
  • Vietnamese

    1.8%
  • Serbian

    1.8%
  • Arabic

    1.8%
  • Italian

    1.8%
  • Croatian

    1.8%
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Senior Investigator

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Senior Investigator Education

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Real Senior Investigator Salaries

Job Title Company Location Start Date Salary
Senior Investigator National Institutes of Health, HHS Bethesda, MD Nov 02, 2014 $300,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Jan 11, 2015 $265,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Mar 15, 2010 $230,000
Senior Investigator Los Angeles Biomedical Research Institutute Torrance, CA Apr 01, 2012 $200,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Aug 30, 2012 $191,300
Senior Investigator National Institutes of Health, HHS Bethesda, MD Aug 30, 2009 $178,464
Senior Investigator National Institutes of Health, HHS Rockville, MD Oct 21, 2015 $165,360
Senior Investigator Novartis Pharmaceuticals Corporation East Hanover, NJ Feb 17, 2012 $162,029
SR. Investigator H3 Biomedicine Inc. Cambridge, MA Aug 16, 2014 $158,500
Senior Investigator National Institutes of Health, HHS Bethesda, MD Mar 01, 2015 $150,800
Senior Investigator National Institutes of Health, HHS Rockville, MD Mar 01, 2015 $150,800
Senior Investigator National Institutes of Health, HHS Rockville, MD Oct 21, 2012 $150,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Sep 20, 2015 $146,000
Senior Investigator National Institutes of Health, HHS Rockville, MD Nov 07, 2013 $140,000
Senior Investigator I, Biomarker Development Novartis Institutes for Biomedical Research, Inc. Cambridge, MA Dec 15, 2012 $130,029
Interim Senior Investigator, Research Informatics Northshore University Healthsystem Evanston, IL Dec 01, 2011 $125,008
SR. Investigator H3 Biomedicine Inc. Cambridge, MA Aug 05, 2015 $105,539 -
$164,048
Senior Investigator Arqule, Inc. Woburn, MA Jul 31, 2011 $96,263

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Top Skills for A Senior Investigator

BackgroundInvestigationsInsuranceFraudLawEnforcementAgenciesEnsureComplianceProceduresPersonnelSurveillanceFinancialCrimesSARSafetyLossInvestigativeReportsSuspiciousActivityNewInvestigatorsCompanyAssetsComplexInvestigationsCriminalInvestigationsLocalLawEnforcementCourtProceedingsDueDiligence

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Top Senior Investigator Skills

  1. Background Investigations
  2. Insurance Fraud
  3. Law Enforcement Agencies
You can check out examples of real life uses of top skills on resumes here:
  • Demonstrated knowledge and experience to conduct highly effective traditional investigations, background investigations, and security investigations.
  • Assigned as a Senior Investigator in South Florida region (remote employee) to investigate insurance fraud in personal injury claims.
  • Prepare case summaries including data analysis for referral to government and law enforcement agencies.
  • Conduct over 100 compliance examinations on commercial vessels to ensure compliance with minimal standards required by Federal regulations.
  • Developed strategies and procedures to reduce theft during the transportation and warehousing of Target Corporation assets.

Top Senior Investigator Employers