Special investigator jobs near me - 75 jobs

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 Columbus, OH 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.

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 an Experienced Field Investigator to conduct surveillance and investigative activities to identify potential fraudulent insurance claims. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients. KEY RESPONSIBILITIES: Case Preparation: Prepare for surveillance assignment by reviewing Ethos' preliminary reports and case information. Field Surveillance: Perform covert surveillance from your vehicle by tracking and capturing high-quality video evidence of surveillance targets. Report Writing: Draft detailed and court-ready investigative reports summarizing activity and key findings. Documentation: Finalize case file by submitting case reports and uploading video footage via personal laptop at the end of the day. Communication: Work closely with the field supervisor and operations teams, receiving regular guidance and mentorship. REQUIREMENTS: Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports. Driver's License: Valid driver's license and proof of automobile insurance. Personal Vehicle: A well-maintained vehicle that is always reliable (preferably with tinted windows). Surveillance Equipment: A handheld camcorder with high-quality zoom and a covert camera device. Use of stabilization equipment (gimbals, tripods, etc.) is strongly encouraged. Technology: A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks. Private Investigator License: Active Private Investigator license or willingness to obtain one (where required by state). 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 Most surveillance cases start at 6:00AM. End time can vary depending on activity and a typical workday can vary from 3-12 hours. Weekends/holidays are common workdays as claimants are more likely to be active. This is an independent role often requiring long hours alone in your vehicle, regardless of weather conditions. Must remain alert with no external distractions, ready to use videography equipment to document subjects. 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.

PRODIGY INVESTIGATIONS OFFERS TOP PAY FOR SUPERIOR RESULTS! We are seeking e xperienced Background Investigator candidates throughout the country. This is a remote position. Over the past 43 years, Prodigy Investigations has saved employers and insurance carriers 100's of Millions of Dollars . More than 50,000 employers have trusted Prodigy Investigations to solve big problems fast, close claims quicker, and save more money. Prodigy Investigations is the best choice to refute fraudulent claims. Job duties include, but are not limited to: setup new surveillance cases in database, conduct pre-surveillance research, research locations, backgrounds, and social media profiles, assistance with claims investigations, locates, online investigations, court research, and report writing. This is a fun, dynamic, and exciting career! Every day is unpredictable. Job Duties include: Internet research Social media investigations Locates Vehicle identification Asset Investigations Pre Surveillance Planning Develop address histories New surveillance investigations intake Data entry Driving records License plate searches Pre-employment background checks Court research & public records requests Freedom of Information Act requests Report writing Open Source Intelligence (OSINT)

Background Investigator - Independent Contractor/1099 Federal Background Investigations Division 1FORCE is currently seeking to engage with experienced Contractors and federally credentialed Background Investigators to conduct personnel security background investigations in a contractor capacity in support of our client's contracts with the federal government. We have work nationwide and if you currently hold credentials on a federal personnel security background investigations contract (or have held government credentials in the last 2 years), we want to partner to provide immediate, weekly work opportunities. DUTIES & RESPONSIBILITIES: Complete record searches. Conduct face-to-face interviews to elicit information about applicants seeking federal positions, contract positions or positions within the military. Obtain factual information from a variety of personal and record sources to produce a report of investigation, containing all pertinent facts, of an individual's background and character, in accordance with agency guidelines and instructions. Investigators work from home, set their own schedules, and work independently. Self-motivated, highly independent, and prepared to work non-traditional hours (i.e., evenings and weekends). POSITION REQUIREMENTS: Federally credentialed and experienced investigators will have met the background investigations national training standards and have 12 months or more of consecutive experience performing executive branch investigations. Superior organizational and time management skills. Excellent communication skills in both oral and written formats. Strong computer and typing skills for composing narrative reports of investigation in FWS and utilizing PIPS or other federally supported case management/reporting system. Sufficient E&O liability, car insurance and personal insurance. **All candidates must be a US Citizen and be able to obtain a TOP SECRET level security clearance.

Type of Requisition: Regular Clearance Level Must Currently Possess: None Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: None Job Family: Intelligence Operations and Analysis Job Qualifications: Skills: Evaluate Information, Microsoft Office 365, Research Analysis Certifications: None Experience: 3 + years of related experience US Citizenship Required: No Job Description: Marketplace InvestigatorThe Affordable Care Act (ACA) requires every state to establish a health insurance exchange (also called Health Insurance Marketplace) to facilitate the purchase of health insurance for individuals and small businesses. Through the Center of Program Integrity (CPI), the Centers for Medicare & Medicaid Services (CMS) has strong oversight and internal controls to protect consumers enrolled in the Marketplaces and safeguard taxpayer dollars. CMS develops and enforces rules for insurance agents, brokers, and others who assist with FFM enrollments. The Marketplace Program Integrity Contract (MPIC) is designed to support this oversight. Through research, investigation, and data analysis, the desired outcomes of the MPIC efforts are to prevent, detect, and resolve noncompliance with Marketplace rules, requirements, and laws; recommend administrative actions to CMS; and recommend referrals to law enforcement if potential fraud and abuse is identified.HOW YOU WILL MAKE AN IMPACT:Conducts analysis, research, and outreach in support of an MPIC Team. Research includes review of documents and data; outreach includes interaction with consumers, insurance agents/brokers, and other agencies; analysis includes applying regulations to findings and analysis of data, including enrollment data related to consumer and Agent/Broker activity within the health insurance exchange. Completes and/or supports the preparation of comprehensive reports on the results of analysis and other work completed by team members. Conducts other data analysis and documentation support as needed.Will focus on reviewing documents provided by agent/brokers in response to Marketplace registration/agreement suspension or termination and preparing recommendation based on review conducted. Work collaboratively within a team of ACA policy subject matter experts (SMEs) and data analysts. Actively participate in the development of lead and investigation workflows and required data capture within a case management system. Strictly follow approved Standard Operating Procedures (SOPs) for conducting investigations and provide input into recommendations for SOP updates as needed. Prioritize, evaluate, and analyze information for potential fraud, waste, and abuse (FWA) using data related to consumer enrollments into qualified health plans and/or the associated agents/brokers' compliance with regulations. Analyze and evaluate enrollment data related to consumer and Agent/Broker activity within the Marketplace. As needed, initiate and develop an Investigative Plan of Action (IPOA) and with CMS approval, implement the plan with the support of investigative staff into the potential FWA behavior using various investigative techniques. As needed, initiate and develop a Case Summary report, which summarizes investigative findings. As needed, make administrative recommendations to CMS based on case summary findings. Within a case management and tracking system, comprehensively document in detail all lead and investigative activity. As needed, conduct interviews with complainants and/or consumers and with CMS approval correspond with agents/brokers or other government agencies using CMS-approved template Actively support preparation of comprehensive reports on the status of leads and investigations as required by CMS. As needed, assist in ad-hoc educational and outreach sessions with partners, e.g., CMS, law enforcement, Agent/Brokers, Navigators, etc. Safeguard PII and PHI Infrequent travel may be required WHAT YOU'LL NEED TO SUCCEED Bachelor's degree or equivalent experience in healthcare field that includes 2-4 years' ACA and/or Medicaid-Medicare experience 2+ years' experience with and/or understanding of ACA policies and regulations related to consumer enrollments requirements and Agent/Broker and Navigator responsibilities Frequent work with workgroups to successful completion of goals and milestones Experience reviewing complex data reports Highly organized, ability to multi-task, and meet deadlines Proficient in computer skills, for example Microsoft Office-Word, Excel Requires only limited oversight to conduct work Strong inter-personal and communications skills, both written and oral Experience in conducting telephonic and in-person interviews Ability to conceptualize, solve problems, and draw conclusions Value-Add Experience - Preferred Skills Experience with FWA claims and investigations Location: Remote Residency/background: Must be able to pass a CMS background check, which requires residency in the U.S. for 3 of the last 5 years. GDIT IS YOUR PLACE: 401K with company match Comprehensive health and wellness packages Internal mobility team dedicated to helping you own your career Professional growth opportunities including paid education and certifications Cutting-edge technology you can learn from Rest and recharge with paid vacation and holidays #GDITHealth#healthcarefraud#CMSThe likely salary range for this position is $72,877 - $98,599. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range. Scheduled Weekly Hours: 40 Travel Required: Less than 10% Telecommuting Options: Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee's date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.Join our Talent Community to stay up to date on our career opportunities and events at gdit.com/tc. Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans

Our Company At AssuranceAmerica, we are more than a unique blend of insurance assets. We believe in creating a culture where every associate has the opportunity to learn and grow. We strive to create a work environment to meet associate needs and we are determined to achieve excellence in everything we do. This is an opportunity to join a dynamic team in a company that is a leader in the non-standard auto insurance space and functions with a small company, entrepreneurial style. This position will require someone with an understanding that one needs to have a “roll up your sleeves” attitude to help make things happen. Job Summary The SIU Investigator is responsible for conducting thorough investigations throughout the 10 states in which we conduct business. The Investigator is responsible for analytical review of suspicious claims utilizing various investigative methods and techniques. The investigator must evaluate relevant information essential in resolving suspicious and complex investigations. This position requires demonstrated effectiveness in the understanding and application of legal and claim principles. The SIU Investigator works under minimal supervision outside the office and would have access to transportation. Only candidates located in the Orlando area will be considered. This is a field position. Please note a company car provided. Job Responsibilities Supports Claims Department operations in the research and investigation of suspicious or questionable property damage and injury claims Conducts recorded statements and Examinations Under Oath as required Completes field work as required. Documents claim files and communicates in writing as required Provides office training to ensure recognition of potentially suspicious or fraudulent files in the branch Reports suspicious claims to the department of insurance as required by statute Must ensure compliance with industry and company policies Must understand regulatory / statutory requirements; develops and maintains knowledge of changes in law both at state and national levels Properly utilizes our claims and other various systems Attends industry meetings for communication trends Completes individual monthly Investigator report to manager Attends and participates in team meetings Participates in roundtable meetings Actively affiliates and maintains network of SIU, claims, law enforcement, attorney and related contacts to ensure investigation methods are current and proper operating procedures are utilized Responsible for meeting individual goals and objectives Maintains consistent, fair and diplomatic interactions with co-workers Performs other duties as assigned by SIU Manager Job Qualifications Formal Education & Certification Undergraduate College Degree or equivalent work experience will be considered. Knowledge & Experience 5 years of special investigation experience required. Casualty and PIP claims, as well as medical clinic investigations will be highly preferred. Claims and Property Damage investigations experience will be required. Skills & Competencies Must be able to work in a fast-paced, paperless/automated production environment. Excellent PC skills are required. Excellent communication/interpersonal skills and ability to work with all levels within the organization and deal tactfully and diplomatically with public and outside authorities. Must be able to work as a team player throughout the company. Ensures that the highest degree of professionalism and integrity is maintained, and that decisions are made within the scope of what is fair, reasonable and appropriate according to applicable law and industry standards. Must have the ability to travel when necessary. Bilingual preferred. Florida Adjuster's license is required prior to employment start date.

Affirmative Civil Enforcement (ACE) InvestigatorEmployment Type: Full-Time, Experienced Department: Legal Services CGS is seeking an experienced ACE Investigator with extensive knowledge and skills in investigative techniques and fraud detection to provide assistance for a large Federal agency initiative. CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success:- The investigator will generate new investigations, and to continue with ongoing investigation and civil actions involving fraud in areas such as healthcare, contracting, and grants, as well as other fraud and abuse of federal public funds and programs. - Regularly meets with the ACE attorneys and with designated agency personnel for the purpose of generating fraud investigations. - Performs a variety of ancillary investigations-related services in direct support of any assigned fraud- Utilizes electronic databases such as public records, property records, business records, and other government-maintained databases, to identify documents, witnesses and other physical evidence. - Prepares reports on progress of investigations for use by AUSAs and supervisory attorneys. These reports may include significant findings and conclusions, analyses of information located in electronic databases, presentations, recommendations for additional investigative actions and candid assessments of strengths and weaknesses of witnesses, documentary evidence, or other aspects of a case. - Examines books, ledgers, payrolls, cost reports, billing statements, invoices, correspondence, computer data, and other records pertaining to the transactions, events, or allegations under investigation. - Performs sophisticated analyses of large-scale hard-copy and electronic data, such as health care claims data, financial transaction data, accounting records, or bank records to develop investigative leads and to determine their potential relevance to the allegations at issue. - Gathers and analyzes facts including witness statements, timelines, and scientific or technical data for the purpose of advancing investigative objectives. Establishes and verifies relationships between facts and evidence obtained or presented to confirm authenticity of documents, to corroborate witness statements, and to otherwise build proof necessary for successful litigation or settlement. - Develops and analyzes evidence and collects information relating to such evidence, or other legal matters under consideration, from appropriate primary and secondary sources. Performs analysis to clarify the target suspect's or organization's pattern of operations, to identify information relevant to the legal issues involved, and to recommend valuable approaches to the AUSAs or other members of the investigative team. Develops and refines proof required to assist in determining legal responsibility for violations. - Assists ACE AUSAs with in-person and/or telephonic interviews of witnesses, depositions, and sworn witness examinations. - Assists with the preparation and service of subpoenas for documentary materials, interrogatory answers, or witness testimony in connection with ACE investigations. - Develops an understanding of all applicable federal, state, or local laws to the extent necessary to make sound decisions on direction and scope of investigations. Determines proof required to affix responsibility for violations, and devise methods for obtaining, preserving, and presenting evidence to the greatest effect. - Assists with determining the most efficacious methods for planning, scheduling, and conducting investigations, and identifies any resources that may be required. - Performs other related ACE investigator duties as assigned and within scope. - Attends meetings and trainings as may be required and appropriate. Qualifications:- Computer Skills: Applicant shall have the ability to use MS Word, MS Excel, MS Outlook, MS Access, and other databases as well as Adobe Acrobat Professional. Experience with working on document review/management platforms such as Relativity, with analyzing spreadsheets of claims data, and with utilizing docketing software is a plus. - Ability to review and understand the import of a wide variety of documents, both legal and non-legal, including Motions and Briefs. - Ability to think independently and to develop investigative strategies in response to the needs of a specific case. - Communication skills are extremely important. Applicant shall work and interact professionally and effectively with all levels of staff. - Ability to meet established deadlines and work as a team player in a professional office. - Skill in meeting and dealing with people in a courteous and tactful manner. Our Commitment:Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client's specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we've been growing our government-contracting portfolio, and along the way, we've created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package. - Health, Dental, and Vision- Life Insurance- 401k- Flexible Spending Account (Health, Dependent Care, and Commuter)- Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Join our team and become part of government innovation! Explore additional job opportunities with CGS on our Job Board:******************* com/join-our-team/For more information about CGS please visit: ************ cgsfederal. com or contact:Email: info@cgsfederal. com #CJ

Hours: 40 Pay Details: $29.75 - $47.75 USD TD is committed to providing fair and equitable compensation opportunities to all colleagues. Growth opportunities and skill development are defining features of the colleague experience at TD. Our compensation policies and practices have been designed to allow colleagues to progress through the salary range over time as they progress in their role. The base pay actually offered may vary based upon the candidate's skills and experience, job-related knowledge, geographic location, and other specific business and organizational needs. As a candidate, you are encouraged to ask compensation related questions and have an open dialogue with your recruiter who can provide you more specific details for this role. Line of Business: Financial Crime Risk Management Job Description: Department Overview: Our team currently operates under a primarily offsite work model, employees must be available to come into a TD location for "moments that matter" at a frequency determined by the business. The Financial Crime Risk Investigator II conducts investigations of moderate complexity for both internal and external cases. Recommends for demarket and/or freezing accounts by the appropriate investigative unit. Conducts adjudications of moderate complexity. May provide QA/review and mentorship of a team. Applies reasonable grounds to suspect money laundering and terrorist financing. Depth & Scope: Experienced working professional role providing services, advisory or processes/program support Requires experienced, conceptual, and practical knowledge within respective area and knowledge of broader related areas Accountable for own work and sometimes others; acts as an escalation point or knowledge resource for others in their own area Leads projects or work streams within broader projects with moderate risk and may be accountable for ongoing activities, processes, and functional programs Works within broad guidelines/policies and independently performs tasks from end to end Work performed under minimal management guidance and supervision Education & Experience: Undergraduate degree or equivalent work experience 3+ years experience Preferred Skills: Prior AML (Anti-Money Laundering) investigations experience, within a financial institution or regulatory environment Strong knowledge of Suspicious Activity Reports, Bank Secrecy Act, and other relevant AML regulations Familiarity with current AML typologies and emerging financial crime trends in the banking sector Experience working in federal law enforcement or financial crime units Strong written and oral communication skills with an emphasis on investigative and stakeholder reporting. Customer Accountabilities: Conducts investigative analysis by collecting, assessing, and collating case file information for AML, Sanctions/ABAC & Financial Crime investigations Conducts data analysis, manipulation and interpretation looking for patterns and anomalies Initiates investigations and/or responds to emerging AML and Sanctions/ABAC risks Assists with reviewing and investigating court orders (subpoenas) related to criminal actions Assists and coordinates investigations with various law enforcement agencies as delegated Prepares and delivers AML, Sanctions/ABAC & Financial Crime and/or fraud detection/loss prevention training or updates to Bank Employees or other agencies as assigned Shareholder Accountabilities: Leads workstreams by acting as a project lead for medium scale projects/initiatives in accordance with project management methodologies Consistently exercises discretion in managing correspondence, information, and all matters of confidentiality; escalates issues where appropriate Conducts reporting and/or meaningful analysis at the functional or enterprise level using results to draw conclusions, makes recommendations, assesses the effectiveness of programs/policies/practices Be knowledgeable of practices and procedures within own area of responsibility and keeps abreast of emerging trends for own functional area Protects the interests of the organization - identifies and manages risks, and escalates non-standard, high-risk transactions/activities as necessary Maintains appropriate project records, databases, and information; reports to management and others on project status and updates Monitors service, productivity and assesses efficiency levels within own function and implements continuous process/performance improvements where opportunities exist Acquires and applies expertise in the discipline, provides guidance, assistance, and direction to Analysts, Investigators and others Identifies, recommends, and effectively executes standard practices applicable to the discipline Adheres to internal policies/procedures and applicable regulatory guidelines Keeps abreast of emerging issues, trends, and evolving regulatory requirements and assesses potential impacts Maintains a culture of risk management and control, supported by effective processes in alignment with risk appetite Employee/Team Accountabilities: Participates fully as a member of the team, supports a positive work environment that promotes service to the business, quality, innovation and teamwork and ensures timely communication of issues/points of interest Supports the team by continuously enhancing knowledge/expertise in own area and participates in knowledge transfer within the team and business unit Keeps current on emerging trends/developments and grows knowledge of the business, related tools and techniques Participates in personal performance management and development activities, including cross training within own team Keeps others informed and up to date about the status/progress of projects and/or all relevant or useful information related to day-to-day activities Contributes to the success of the team by willingly assisting others in the completion and performance of work activities; provides training, coaching and/or guidance as appropriate. Contributes to a fair, positive and equitable environment that supports a diverse workforce Acts as a brand champion for your business area/function and the bank, both internally and/or externally Physical Requirements: Never: 0%; Occasional: 1-33%; Frequent: 34-66%; Continuous: 67-100% Domestic Travel - Occasional International Travel - Never Performing sedentary work - Continuous Performing multiple tasks - Continuous Operating standard office equipment - Continuous Responding quickly to sounds - Occasional Sitting - Continuous Standing - Occasional Walking - Occasional Moving safely in confined spaces - Occasional Lifting/Carrying (under 25 lbs.) - Occasional Lifting/Carrying (over 25 lbs.) - Never Squatting - Occasional Bending - Occasional Kneeling - Never Crawling - Never Climbing - Never Reaching overhead - Never Reaching forward - Occasional Pushing - Never Pulling - Never Twisting - Never Concentrating for long periods of time - Continuous Applying common sense to deal with problems involving standardized situations - Continuous Reading, writing and comprehending instructions - Continuous Adding, subtracting, multiplying and dividing - Continuous The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The listed or specified responsibilities & duties are considered essential functions for ADA purposes. #LI-AMCBCorporate Who We Are: TD is one of the world's leading global financial institutions and is the fifth largest bank in North America by branches/stores. Every day, we deliver legendary customer experiences to over 27 million households and businesses in Canada, the United States and around the world. More than 95,000 TD colleagues bring their skills, talent, and creativity to the Bank, those we serve, and the economies we support. We are guided by our vision to Be the Better Bank and our purpose to enrich the lives of our customers, communities and colleagues. TD is deeply committed to being a leader in customer experience, that is why we believe that all colleagues, no matter where they work, are customer facing. As we build our business and deliver on our strategy, we are innovating to enhance the customer experience and build capabilities to shape the future of banking. Whether you've got years of banking experience or are just starting your career in financial services, we can help you realize your potential. Through regular leadership and development conversations to mentorship and training programs, we're here to support you towards your goals. As an organization, we keep growing - and so will you. Our Total Rewards Package Our Total Rewards package reflects the investments we make in our colleagues to help them and their families achieve their financial, physical and mental well-being goals. Total Rewards at TD includes base salary and variable compensation/incentive awards (e.g., eligibility for cash and/or equity incentive awards, generally through participation in an incentive plan) and several other key plans such as health and well-being benefits, savings and retirement programs, paid time off (including Vacation PTO, Flex PTO, and Holiday PTO), banking benefits and discounts, career development, and reward and recognition. Learn more Additional Information: We're delighted that you're considering building a career with TD. Through regular development conversations, training programs, and a competitive benefits plan, we're committed to providing the support our colleagues need to thrive both at work and at home. Colleague Development If you're interested in a specific career path or are looking to build certain skills, we want to help you succeed. You'll have regular career, development, and performance conversations with your manager, as well as access to an online learning platform and a variety of mentoring programs to help you unlock future opportunities. Whether you have a passion for helping customers and want to expand your experience, or you want to coach and inspire your colleagues, there are many different career paths within our organization at TD - and we're committed to helping you identify opportunities that support your goals. Training & Onboarding We will provide training and onboarding sessions to ensure that you've got everything you need to succeed in your new role. Interview Process We'll reach out to candidates of interest to schedule an interview. We do our best to communicate outcomes to all applicants by email or phone call. Accommodation TD Bank 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, age, disability, status as a protected veteran or any other characteristic protected under applicable federal, state, or local law. If you are an applicant with a disability and need accommodations to complete the application process, please email TD Bank US Workplace Accommodations Program at ***************. Include your full name, best way to reach you and the accommodation needed to assist you with the applicant process.

Job Description Care Access is working to make the future of health better for all. With hundreds of research locations, mobile clinics, and clinicians across the globe, we bring world-class research and health services directly to communities that often face barriers to care. We are dedicated to ensuring that every person has the opportunity to understand their health, access the care they need, and contribute to the medical breakthroughs of tomorrow. With programs like Future of Medicine , which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers , which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Through partnerships, technology, and perseverance, we are reimagining how clinical research and health services reach the world. Together, we are building a future of health that is better and more accessible for all. To learn more about Care Access, visit ******************* How This Role Makes a Difference The Sub-Investigator will be responsible for regional travel mixed with remote tele-medicine work to support our clinical research. Care Access is looking for Nurse Practitioners or Physicians Assistants to support clinical trial related activities in states throughout the USA. How You'll Make An Impact Work closely with the Principal Investigator to oversee the execution of study protocols, delegating study related duties to site staff, as appropriate, and ensuring site compliance with study protocols, study-specific laboratory procedures, standards of Good Clinical Practice (GCP), Standard Operating Procedures (SOPs), quality (QA/QC) procedures, OSHA guidelines, and other state and local regulations as applicable Attends and participates in meetings with the director, other managers, and staff as necessary Complies with regulatory requirements, policies, procedures, and standards of practice Read and understand the informed consent form, protocol, and investigator's brochure Be available to see subjects virtually or in-person as dictated by project design, answer their questions, and resolve medical issues during the study visit Sign and ensure that the study documentation for each study visit is completed Perform all study responsibilities in compliance with the IRB approved protocol Review screening documentation and approves subjects for admission to study Review admission documentation and approves subject for randomization Provide ongoing assessment of the study subject/patient to identify Adverse Events Ensure that serious and unexpected adverse events are reported promptly to the Pl Review and evaluates all study data and comments to the clinical significance of any out of range results Perform physical examinations as part of screening evaluation and active study conduct Provide medical management of adverse events as appropriate The Expertise Required Excellent working knowledge of medical and research terminology Excellent working knowledge of federal regulations, good clinical practices (GCP) Ability to communicate and work effectively with a diverse team of professionals Strong organizational skills: Able to prioritize, support, and follow through on assignments Communication Skills: Strong verbal and written communication skills as evidenced by positive interactions with coworkers, management, clients and vendors Team Collaboration Skills: Work effectively and collaboratively with other team members to accomplish mutual goals. Bring positive and supportive attitude to achieving these goals Strong computer skills with demonstrated abilities using clinical trials database, IVR systems, electronic data capture, MS word and excel Ability to balance tasks with competing priorities Critical thinker and problem solver Curiosity and passion to learn, innovate, able to take thoughtful risks and get things done Friendly, outgoing personality; maintain a positive attitude under pressure High level of self-motivation and energy Ability to work independently in a fast-paced environment with minimal supervision Must have a client service mentality Certifications/Licenses, Education, and Experience: Nurse Practitioner or Physician Assistant with 5+ years of clinical experience Currently licensed in good standing in one or more states listed above A minimum of 1 year of relevant work experience as Sub-Investigator (preferred) in a Clinical Research setting How We Work Together Location: This role is 100% on-site at our Memphis, TN clinic. Travel: This is a remote position with less than 10% travel requirements. Occasional planned travel may be required as part of the role. Physical demands associated with this position Include: The ability to use keyboards and other computer equipment. Benefits & Perks Paid Time Off (PTO) and Company Paid Holidays 100% Employer paid medical, dental, and vision insurance plan options Health Savings Account and Flexible Spending Accounts Bi-weekly HSA employer contribution Company paid Short-Term Disability and Long-Term Disability 401(k) Retirement Plan, with Company Match Diversity & Inclusion We work with and serve people from diverse cultures and communities around the world. We are stronger and better when we build a team representing the communities we support. We maintain an inclusive culture where people from a broad range of backgrounds feel valued and respected as they contribute to our mission. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to, and will not be discriminated against on the basis of, race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. Care Access is unable to sponsor work visas at this time. If you need an accommodation to apply for a role with Care Access, please reach out to: ********************************

Individual is an Investigator, responsible for conducting criminal investigations and to pursue prosecution of the offenders of felonies and/or other crimes against person(s), property, or the State of Ohio. To possess the skills, knowledge and physical ability to successfully carry out the required duties set forth. Physical presence is necessary in the office. Regular, predictable and prompt attendance is needed. The investigator represents the Prosecuting Attorney and the State of Ohio in court, in the community, to law enforcement, to victims, to witnesses, and the general public. Equipment: Ability to operate normal office equipment such as computer, copier, fax machine, telephone, calculator, paper shredder, motor vehicle, and other equipment necessary to perform duties. Knowledge of apple devices such as an iPad with recording application, camera, cell phone and electronic recording devices. Good understanding of and ability to use Microsoft Office (Word, Excel, Outlook and Power Point) and Internet (Explorer and Chrome). Critical skills/expertise: * Knowledge of the Ohio Revised Code, criminal case law, and criminal procedure. * Ability to communicate effectively, both orally and in writing. * Superior interpersonal skills, including the ability to deal with other people possessed of widely varied levels of education and competence. * Demonstrates integrity and reliability, and ability to maintain confidentiality. * Ability to evaluate risks and exercise sound judgment, making decisions in complex and sometimes ambiguous situations that carry significant implications for the citizens of Delaware County. * Ability to work under pressure and to capably interact with co-workers and other members of various departments and agencies. * Ability to develop reports and visual aids that are: concise, accurate and complete for court. * Possesses the ability and knowledge of appropriate elements of criminal offenses, and to determine the perpetrator's method and motive. * Ability and knowledge to transition from an interview technique to an interrogation technique. * Ability and knowledge to audit complex financial transactions and investigate fraud abuse. * Ability and knowledge to make logical and practical decisions independently with little, or no, supervision. * Ability to evaluate credibility and reliability of suspects, victims, and witnesses. Educational and Licensing requirements: Completion of a secondary education or equivalent plus certification from the Ohio Peace Officers Training Council plus (3) year related work experience. Work may involve confrontational situations on a regular basis. Investigator must be able to quickly react, handle and defuse potentially threatening situations. Must possess a valid Ohio driver's license, have an acceptable driving record and maintain a clean criminal record. * Assists Prosecutors with their preparation and presentation in court * Aids in the collection of documents or records, photos or x-rays, evidence of fact or physical properties, that are necessary to prove matters of criminal nature * Conducts interviews and/or take sworn statements from victims and witnesses and possibly offenders * Collects evidence and develop audio/video aids for court * Analyzes complex white collar crime cases * Testifies in court * Follows-up leads from local law enforcement to collect additional information and/or evidence in preparation for trial of criminal cases * Prepares Memorandum of Interviews and/or Summaries of Investigation * Develops and follow-up on intelligence reports * Conducts background investigations of suspects and/or defendants; co-defendants; and/or candidates for the Diversion Program * Utilizes data basis programs restricted to Law Enforcement * Attends intelligence meetings and/or informational meetings and coordinate investigation with local law enforcement agencies * Conducts specialized and generalized investigations * Serves subpoenas to victims; witnesses; or various institutions * Serves notices of Indictment to Offenders * Transports victims and witnesses to/from court * Other duties as assigned by the Prosecuting Attorney Reporting: Individual reports directly to the Criminal Chief, Executive Administrator and the Prosecuting Attorney. The individual exercises independent judgment with direction.

Job DescriptionDescriptionHealthcare Fraud Shield, a leader in healthcare fraud prevention and payment integrity solutions, is looking for a talented Coder or Clinical Coder/Fraud Investigator to join our team. Key Responsibilities Work with SIU Team (Clinical Reviewers, CPCs, Investigators, Analysts-including performing quality check on work, assisting in research, discuss to make appropriate coding determinations as needed) Analyze and interpret patient medical records (behavioral related and other specialties) pertaining to FWA investigations as needed Compare to information submitted on the claims in order to determine amount and nature of billable services as needed Determines appropriateness of billing and reimbursement as needed Documents findings for each claim line in a spreadsheet as needed Summarize findings in a written report as needed Abstracts CPT, HCPCS, Revenue Codes, DRG codes, and ICD-9/ICD-10 from medical records as needed Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations as needed Perform data analysis and lead generation/data mining of client data as needed Conduct various aspects of FWA investigations as needed Provide Subject Matter Expertise and SIU support to clients as needed Comply with Privacy and Security standards Understands and complies with all company Privacy and Security standards Employee may not use or disclose any protected health information, except as otherwise permitted, or required, by law Other duties as needed Skills, Knowledge and Expertise Knowledge of medical terminology Knowledge of coding including CPT, HCPCS, Revenue Codes, DRG Codes, and ICD-10 Knowledge of specialty medical practices Must be detail oriented Ability to communicate effectively both verbally and in writing Strong listening skills Independent Responsible Self-disciplined Ability to meet defined performance and production goals Strong computer skills This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management CERTIFICATE/LICENSE Certified Professional Coder - (CPC ) through governing body AAPC or equivalent certification Minimum of one year of coding and/or billing experience is required. Benefits Medical, Dental & Vision insurance 401(k) retirement savings with employer match Vacation and sick paid time off 7 paid holidays & 2 floating holidays Paid maternity/paternity leave Disability & Life insurance Flexible Spending Account (FSA) Employee Assistance Program (EAP) Professional and career development initiatives Remote work eligible REMOTE WORK REQUIREMENTS Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload. Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Treliant is a global consulting firm serving banks, mortgage originators and servicers, FinTechs, and other companies providing financial services. We are led by practitioners from the industry and the regulatory community who bring deep domain knowledge to help our clients drive business change and address the most pressing compliance, regulatory, and operational challenges. We provide data-driven, technology-enabled advisory and consulting, implementation, staffing and managed services solutions to the regulatory compliance, risk, financial crimes, and capital markets functions of our clients. Founded in 2005, Treliant is headquartered in Washington, DC, with offices across the United States, London, Belfast, and Łódź, Poland. For more information visit ***************** Treliant is committed to fostering a diverse, equitable and inclusive environment that values and embraces all races, religions, ages, abilities, gender, sexual orientations, ethnicities, languages, nationalities, political parties, socioeconomic groups and other characteristics that inform an individual worldwide view and experiences and systems of beliefs (“the principles”). We believe in championing every voice and ensuring everyone's full potential. We are looking for Financial Crimes Investigators with an expertise in blockchain and cryptocurrencies to join our team for remote, project-based opportunities. Responsibilities While the scope of each project may be different, your duties & responsibilities may include: Conduct thorough Blockchain Tracing investigations into potential financial crimes, including AML, fraud, and sanctions violations. Ensure clients meet regulatory and compliance standards by performing EDD/ CDD checks, KYC assessments and analyzing source of funds. Analyze cryptocurrency transactions and wallet addresses, leveraging blockchain explorers and analytics tools to track illicit activity or suspicious behavior. Draft and submit SARs to relevant authorities Identify and assess potential financial crime risks across all client portfolios, leveraging both traditional and crypto-related financial systems. Work closely with regulatory agencies, and financial institutions to ensure compliance with global anti-money laundering (AML) and counter-financing of terrorism (CFT) regulations. Investigate high-volume or high-value transactions, including cross-border transfers, to identify red flags or signs of illegal activities. Qualifications Strong education background; Bachelor's Degree preferred. 3+ years of experience in Financial Crime; either directly with a bank/financial institution or via a third party providing consulting services. Strong background in AML, CTF or Sanctions, with an understanding of the compliance and regulatory frameworks that apply. Familiarity with cryptocurrency blockchain tracing and blockchian technologies including investigating transactions on blockchain platforms and identifying risks associated with digital assets. Familiarity with blockchain forensics tools such as Chainalysis, Elliptic, or CipherTrace to trace and analyze crypto transactions. Knowledge of global regulatory frameworks for crypto - understanding of evolving cryptocurrency regulations, including FATF's Travel Rule, KYC/AML compliance for digital assets, and the legal landscape around crypto in different regions. Experience in developing risk mitigation strategies for crypto-based financial crimes, including fraud prevention and transaction monitoring in the crypto space. We are committed to being an Equal Opportunity Employer and want to build a diverse, inclusive and authentic workplace. If you are interested in working for Treliant but don't tick all the boxes, we encourage you to apply as you may be the perfect candidate for this or other roles. Benefits Primary Location: Remote Primary Location Salary Range: $50/hr - $60/hr Treliant offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefit package that reflects our commitment to creating a diverse and supportive workplace. In addition to a competitive base salary, candidate is eligible for incentive pay as well as a full range of health benefits, vacation plan, and 401k plan. If you want to be part of a dynamic team of professionals, we invite you to join the team at Treliant. We invest in people, and challenge you to advance your career while achieving your aspirations and goals. Here at Treliant, we pride ourselves on our collaborative team culture, where we embrace diversity of thought and innovation. If you strive for excellence and seek an inclusive environment apply on line treliant.com and follow us on LinkedIn. Right to Work Treliant is not in the position to provide sponsorship for this current position and so applicants must be able to work in the United States without requiring sponsorship. Please note, Treliant receives a high volume of applications for all roles. While we will endeavor to respond to all applicants, this is not always possible. Should you not receive a response to your application within 2 weeks, it is likely that you will have been unsuccessful on this occasion. However, we would like to retain your details on our systems and may contact you should another potentially suitable vacancy arise. Treliant LLC is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, sexual orientation, genetic information, religion, age, disability, or military status in employment or provision of services. When contacted for an interview, an applicant who requires special accommodations due to a disability should notify the office so that proper arrangements can be made.

Qualified candidates are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire damages, auto accidents, commercial claims, finding missing persons, courthouse searches, and other investigative tasks. For this position, you will also need to be fluent in writing, reading and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator, you will be joining an incredible team of investigators and industry leaders. PRINCIPAL RESPONSIBILITIES: Complete recorded detailed interviews of those insured, claimants, witnesses, and others as identified. Complete scene investigations, including photographing. Conduct in-person visit of medical clinics. Complete neighborhood canvasses. Make sound judgments during the course of the investigation. Provide timely progress updates. Complete detailed investigative reports. WHO SHOULD APPLY: Candidates with at least five (5) years of investigations experience are strongly encouraged to 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. POSITION QUALIFICATIONS: MUST have current and active Private Investigation License to be eligible for hire. Self-motivated, determined, and intuitive with a strong initiative and work-ethic. Ability to identify critical issues quickly and accurately. Demonstrate observational, organizational, and listening skills. Excellent oral and written communication. Fluent in Spanish language (writing, reading, speaking). Ability to work independently, as well as in a team. Flexible schedule working weekends, holidays, and possible evenings. Candidate must own a reliable computer, preferably a laptop, with access to high-speed internet and a scanner or fax machine. Must have strong computer and internet skills. Proficient with a digital camera. Must possess a valid driving license and own your reliable vehicle. Applicants must pass an extensive background check. Must be able to pass a drug test with negative results (except when undergoing documented medical treatment). College Degree preferred. COMPENSATION & REIMBURSEMENTS: Hourly Rate is commensurate with education and experience. Paid travel time and reimbursement for mileage, tolls, and other per diem items. READY TO APPLY? Please submit your FULL resume, including salary requirements.

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: $70,800.00 - $113,200.00 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 (hourly/salary): Salary Organization Level 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

Innovative. Collaborative. Client-Focused. Growth-Minded. Caring. These are 5 words used to describe Briljent and the Briljent culture. We are seeking Adult Protective Services Investigators with these same qualities to conduct thorough investigations and document investigation activities involving allegations of abuse, neglect, and exploitation involving endangered adults Briljent is dedicated to hiring a unique team of qualified people to serve our clients. We pledge to continue building a company culture where everyone is valued and accepted. Check out our Communication Creed and Non-Negotiable Items that help define the company culture. And ask us about Never Letting Donkeys In The Pool. Must be eligible to work in the United States. No sponsorships are available currently. While this job does work remotely, this role does require on-site investigations. Travel will be required within the NE region of Indiana. Here are the day-to-day duties of this position: Investigate allegations of abuse, neglect, and exploitation involving endangered adults Conduct thorough investigations, including interviews, record reviews, and collaboration with other investigative agencies Initiate and facilitate referrals to services and community resources Document investigation activities, including case planning, safety planning, case notes, and findings Serve as the Priority A (within 24 hours of receipt) responder to initiate timely contact with clients facing immediate harm on a rotating basis Respond to all assigned investigations within the required timeframe Review and respond to quality assurance evaluations Skills needed to be successful in this role: Ability to think critically, incorporating multiple factors into larger concepts Strong organizational skills with abilities to simultaneously manage multiple investigations Ability to work with and relate to others with customer relation techniques, professionalism, and respect for other cultures Ability to effectively use active listening and interviewing skills Ability to adapt quickly when policies and regulations change Must be computer literate and have MS Word, Excel, Outlook, and Internet skills Ability to foster teamwork with all levels of management and staff Ability to work well independently and within a team Superior verbal and written communication skills Strong decision-making skills, with accuracy and attention to detail Requirements Requirements: Experience with Adult Protective Services, Investigatory, Social Services, Human Services, or Law Enforcement work Bachelor's degree preferred Must have reliable transportation, a valid drivers license, and a clean driving record Must be willing and able to commute to the following Indiana counties: Adams, Allen, Blackford, DeKalb, Elkhart, Grant, Huntington, Jay, Kosciusko, LaGrange, Noble, Steuben, Wabash, Wells, Whitley What else does it take to be successful at Briljent? Consultative Mindset -Listen. Stay client-focused. Understand and prioritize the needs, goals, and concerns of clients. Customize solutions to meet the specific requirements and expectations. Encourage open-communication and collaboration. Flexible - Be open to change and adaptable to new situations, ideas, and approaches. Learning Leader - At Briljent, we seek new ideas, find creative ways to hone skills, and share lessons learned so we can continually bring our best to our clients. It's not always easy. Honestly, it's not always comfortable. But that's okay. We love a good challenge. Impeccable Integrity - Maintain a high level of integrity, honesty and ethics in all interactions and decision making. Do what's right, do what you say you're going to do, and do it all honestly. If this sounds exciting and you have the qualifications plus something unique to add to the team, apply now! Physical Requirements & Environmental Conditions These physical demands must be met by an employee to successfully perform the essential functions of this job. The employee is regularly required to communicate, remain in a stationary position, and utilize technology tools such as a laptop computer for extended periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Equal Opportunity Employer Briljent is a solutions-based company. Solutions come from creative ideas; ideas come from being creative with differences. Briljent believes collaboration and perspective are critical to the success of the company. Employment at Briljent is based on merit and professional qualifications. We do not discriminate against any employee or applicant because of race, creed, color, religion, gender, sexual orientation, national origin, disability, age, veteran status, marital status, or any other basis protected by federal, state, or local law, regulation, or ordinance.

Full-time Description Innovative. Collaborative. Client-Focused. Growth-Minded. Caring. These are 5 words used to describe Briljent and the Briljent culture. We are seeking Adult Protective Services Investigators with these same qualities to conduct thorough investigations and document investigation activities involving allegations of abuse, neglect, and exploitation involving endangered adults Briljent is dedicated to hiring a unique team of qualified people to serve our clients. We pledge to continue building a company culture where everyone is valued and accepted. Check out our Communication Creed and Non-Negotiable Items that help define the company culture. And ask us about Never Letting Donkeys In The Pool. Must be eligible to work in the United States. No sponsorships are available currently. While this job does work remotely, this role does require on-site investigations. Travel will be required within the NE region of Indiana. Here are the day-to-day duties of this position: Investigate allegations of abuse, neglect, and exploitation involving endangered adults Conduct thorough investigations, including interviews, record reviews, and collaboration with other investigative agencies Initiate and facilitate referrals to services and community resources Document investigation activities, including case planning, safety planning, case notes, and findings Serve as the Priority A (within 24 hours of receipt) responder to initiate timely contact with clients facing immediate harm on a rotating basis Respond to all assigned investigations within the required timeframe Review and respond to quality assurance evaluations Skills needed to be successful in this role: Ability to think critically, incorporating multiple factors into larger concepts Strong organizational skills with abilities to simultaneously manage multiple investigations Ability to work with and relate to others with customer relation techniques, professionalism, and respect for other cultures Ability to effectively use active listening and interviewing skills Ability to adapt quickly when policies and regulations change Must be computer literate and have MS Word, Excel, Outlook, and Internet skills Ability to foster teamwork with all levels of management and staff Ability to work well independently and within a team Superior verbal and written communication skills Strong decision-making skills, with accuracy and attention to detail Requirements Requirements: Experience with Adult Protective Services, Investigatory, Social Services, Human Services, or Law Enforcement work Bachelor's degree preferred Must have reliable transportation, a valid drivers license, and a clean driving record Must be willing and able to commute to the following Indiana counties: Adams, Allen, Blackford, DeKalb, Elkhart, Grant, Huntington, Jay, Kosciusko, LaGrange, Noble, Steuben, Wabash, Wells, Whitley What else does it take to be successful at Briljent? Consultative Mindset -Listen. Stay client-focused. Understand and prioritize the needs, goals, and concerns of clients. Customize solutions to meet the specific requirements and expectations. Encourage open-communication and collaboration. Flexible - Be open to change and adaptable to new situations, ideas, and approaches. Learning Leader - At Briljent, we seek new ideas, find creative ways to hone skills, and share lessons learned so we can continually bring our best to our clients. It's not always easy. Honestly, it's not always comfortable. But that's okay. We love a good challenge. Impeccable Integrity - Maintain a high level of integrity, honesty and ethics in all interactions and decision making. Do what's right, do what you say you're going to do, and do it all honestly. If this sounds exciting and you have the qualifications plus something unique to add to the team, apply now! Physical Requirements & Environmental Conditions These physical demands must be met by an employee to successfully perform the essential functions of this job. The employee is regularly required to communicate, remain in a stationary position, and utilize technology tools such as a laptop computer for extended periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Equal Opportunity Employer Briljent is a solutions-based company. Solutions come from creative ideas; ideas come from being creative with differences. Briljent believes collaboration and perspective are critical to the success of the company. Employment at Briljent is based on merit and professional qualifications. We do not discriminate against any employee or applicant because of race, creed, color, religion, gender, sexual orientation, national origin, disability, age, veteran status, marital status, or any other basis protected by federal, state, or local law, regulation, or ordinance.

Applicants must live near Boise, ID. This position is responsible for comprehensive management and ownership of fraud, waste and abuse investigations including development and presentation of investigative results. This individual carries out analytical and process management tasks with a high degree of autonomy. This individual serves as a corporate resource on fraud, waste and abuse issues and recommends cost containment projects with an emphasis on fraud prevention. INVESTIGATIONS Prioritize, triage and manage workload to meet internal performance metrics, regulatory and contractual requirements Use independent judgment to create investigative work plans and develop case strategies based upon analysis of referral data and contractual/regulatory requirements Analyze data and select audit samples using various sampling methodologies Plan and conduct desk audits, field audits and/or site visits Collect and analyze information to evaluate facts and circumstances through an extensive review of data from professional and facility providers, member data, contractual relationships, payment policies, Medicaid/Medicare rules and statutes, etc. Conduct research on medical policies and practices, provider characteristics, and related topics Interview patients, providers, provider staff, and other witnesses/experts Prepare correspondence Obtain and preserve physical and documentary evidence to support investigations Maintain comprehensive case files FRAUD, WASTE AND ABUSE DETECTION Triage and prioritize leads from internal and external sources Use knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability, reimbursement methodologies, and relevant laws to find suspicious patterns in claims data, provider enrollment data, and other sources Remain up to date on published fraud cases, schemes, investigative techniques and methodologies, and industry trends PACKAGING OF FINDINGS AND RECOMMENDATIONS Organize data and prepare a written summary of investigative steps, conclusions, recommendations with attention to detail and a high level of accuracy Prepare clear and concise investigatory reports to support findings of potential fraud, waste and abuse CASE RESOLUTION Identify, communicate and recover losses as deemed appropriate Present case to internal department(s), law enforcement and/or regulatory agencies Support legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions Negotiate settlement agreements with subjects and/or attorneys Assist in preparation, execution, and follow-up of settlement agreement terms CUSTOMER INTERACTIONS Make presentations to customers, prospects, conference audiences, and law enforcement Collaborate, consult, and coordinate regularly with clients on the status and direction of assignments Develop and maintain contacts/liaisons with law enforcement, regulatory agencies, task force members, other company SIU staff and external contacts involved in fraud investigation, detection and prevention MISCELLANEOUS DUTIES Represent client at industry task force meetings and meetings with regulatory agencies Measure and report performance metrics Identify opportunities and make recommendations for reduction of exposure to fraud, waste and abuse Consult on anti-fraud policies and procedures Other duties as assigned The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Minimum of five years of experience in fraud investigations, related behavioral or medical healthcare insurance experience in claims, clinical, auditing, compliance, provider networks, management, or project planning. Demonstrated abilities in time management and establishing priorities. Strong listening and observation skills. Impeccable work ethic, completely dependable, and proactive; a problem solver. Proven ability to effectively handle cases of fraud and abuse in a discreet, confidential, and professional manner. Demonstrated strategic and analytical thinking skills, with ability to effectively communicate conclusions and recommendations to management. Comprehensive, practical knowledge of complex and diverse fraud investigative techniques and methodologies utilized in program audits. Understanding of insurance terms and policy interpretation. Ability to work to tight timelines when necessary. Works independently; collaborates well with peers and customers. Demonstrated ability to manage and prioritize case load with limited supervision. Strong computer skills consisting of Microsoft Excel, Access, Outlook, Word, and Power Point. General Job Information Title SIU Program Integrity Investigator - Remote (In Idaho) Grade 24 Work Experience - Required Fraud Investigations Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's Education - Preferred License and Certifications - Required License and Certifications - Preferred AHFI - Accredited Healthcare Fraud Investigator - EnterpriseEnterprise, CFE - Certified Fraud Examiner - EnterpriseEnterprise, CPC - Certified Professional Coder - EnterpriseEnterprise, LSSBB - Lean Six Sigma Black Belt Certification - EnterpriseEnterprise, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt Salary Range Salary Minimum: $58,440 Salary Maximum: $93,500 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Mount Laurel, New Jersey, United States of America **Hours:** 40 **Pay Details:** $29.75 - $47.75 USD TD is committed to providing fair and equitable compensation opportunities to all colleagues. Growth opportunities and skill development are defining features of the colleague experience at TD. Our compensation policies and practices have been designed to allow colleagues to progress through the salary range over time as they progress in their role. The base pay actually offered may vary based upon the candidate's skills and experience, job-related knowledge, geographic location, and other specific business and organizational needs. As a candidate, you are encouraged to ask compensation related questions and have an open dialogue with your recruiter who can provide you more specific details for this role. **Line of Business:** Financial Crime Risk Management **Job Description:** **Department Overview:** **_Our team currently operates under a primarily offsite work model, employees must be available to come into a TD location for "moments that matter" at a frequency determined by the business._** The _Financial Crime Risk Investigator II_ conducts investigations of moderate complexity for both internal and external cases. Recommends for demarket and/or freezing accounts by the appropriate investigative unit. Conducts adjudications of moderate complexity. May provide QA/review and mentorship of a team. Applies reasonable grounds to suspect money laundering and terrorist financing. **Depth & Scope:** + Experienced working professional role providing services, advisory or processes/program support + Requires experienced, conceptual, and practical knowledge within respective area and knowledge of broader related areas + Accountable for own work and sometimes others; acts as an escalation point or knowledge resource for others in their own area + Leads projects or work streams within broader projects with moderate risk and may be accountable for ongoing activities, processes, and functional programs + Works within broad guidelines/policies and independently performs tasks from end to end + Work performed under minimal management guidance and supervision **Education & Experience:** + Undergraduate degree or equivalent work experience + 3+ years experience **Preferred Skills:** + Prior AML (Anti-Money Laundering) investigations experience, within a financial institution or regulatory environment + Strong knowledge of Suspicious Activity Reports, Bank Secrecy Act, and other relevant AML regulations + Familiarity with current AML typologies and emerging financial crime trends in the banking sector + Experience working in federal law enforcement or financial crime units + Strong written and oral communication skills with an emphasis on investigative and stakeholder reporting. **Customer Accountabilities:** + Conducts investigative analysis by collecting, assessing, and collating case file information for AML, Sanctions/ABAC & Financial Crime investigations + Conducts data analysis, manipulation and interpretation looking for patterns and anomalies + Initiates investigations and/or responds to emerging AML and Sanctions/ABAC risks + Assists with reviewing and investigating court orders (subpoenas) related to criminal actions + Assists and coordinates investigations with various law enforcement agencies as delegated + Prepares and delivers AML, Sanctions/ABAC & Financial Crime and/or fraud detection/loss prevention training or updates to Bank Employees or other agencies as assigned **Shareholder Accountabilities:** + Leads workstreams by acting as a project lead for medium scale projects/initiatives in accordance with project management methodologies + Consistently exercises discretion in managing correspondence, information, and all matters of confidentiality; escalates issues where appropriate + Conducts reporting and/or meaningful analysis at the functional or enterprise level using results to draw conclusions, makes recommendations, assesses the effectiveness of programs/policies/practices + Be knowledgeable of practices and procedures within own area of responsibility and keeps abreast of emerging trends for own functional area + Protects the interests of the organization - identifies and manages risks, and escalates non-standard, high-risk transactions/activities as necessary + Maintains appropriate project records, databases, and information; reports to management and others on project status and updates + Monitors service, productivity and assesses efficiency levels within own function and implements continuous process/performance improvements where opportunities exist + Acquires and applies expertise in the discipline, provides guidance, assistance, and direction to Analysts, Investigators and others + Identifies, recommends, and effectively executes standard practices applicable to the discipline + Adheres to internal policies/procedures and applicable regulatory guidelines + Keeps abreast of emerging issues, trends, and evolving regulatory requirements and assesses potential impacts + Maintains a culture of risk management and control, supported by effective processes in alignment with risk appetite **Employee/Team Accountabilities:** + Participates fully as a member of the team, supports a positive work environment that promotes service to the business, quality, innovation and teamwork and ensures timely communication of issues/points of interest + Supports the team by continuously enhancing knowledge/expertise in own area and participates in knowledge transfer within the team and business unit + Keeps current on emerging trends/developments and grows knowledge of the business, related tools and techniques + Participates in personal performance management and development activities, including cross training within own team + Keeps others informed and up to date about the status/progress of projects and/or all relevant or useful information related to day-to-day activities + Contributes to the success of the team by willingly assisting others in the completion and performance of work activities; provides training, coaching and/or guidance as appropriate. + Contributes to a fair, positive and equitable environment that supports a diverse workforce + Acts as a brand champion for your business area/function and the bank, both internally and/or externally **Physical Requirements:** Never: 0%; Occasional: 1-33%; Frequent: 34-66%; Continuous: 67-100% + Domestic Travel - Occasional + International Travel - Never + Performing sedentary work - Continuous + Performing multiple tasks - Continuous + Operating standard office equipment - Continuous + Responding quickly to sounds - Occasional + Sitting - Continuous + Standing - Occasional + Walking - Occasional + Moving safely in confined spaces - Occasional + Lifting/Carrying (under 25 lbs.) - Occasional + Lifting/Carrying (over 25 lbs.) - Never + Squatting - Occasional + Bending - Occasional + Kneeling - Never + Crawling - Never + Climbing - Never + Reaching overhead - Never + Reaching forward - Occasional + Pushing - Never + Pulling - Never + Twisting - Never + Concentrating for long periods of time - Continuous + Applying common sense to deal with problems involving standardized situations - Continuous + Reading, writing and comprehending instructions - Continuous + Adding, subtracting, multiplying and dividing - Continuous The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The listed or specified responsibilities & duties are considered essential functions for ADA purposes. \#LI-AMCBCorporate **Who We Are:** TD is one of the world's leading global financial institutions and is the fifth largest bank in North America by branches/stores. Every day, we deliver legendary customer experiences to over 27 million households and businesses in Canada, the United States and around the world. More than 95,000 TD colleagues bring their skills, talent, and creativity to the Bank, those we serve, and the economies we support. We are guided by our vision to Be the Better Bank and our purpose to enrich the lives of our customers, communities and colleagues. TD is deeply committed to being a leader in customer experience, that is why we believe that all colleagues, no matter where they work, are customer facing. As we build our business and deliver on our strategy, we are innovating to enhance the customer experience and build capabilities to shape the future of banking. Whether you've got years of banking experience or are just starting your career in financial services, we can help you realize your potential. Through regular leadership and development conversations to mentorship and training programs, we're here to support you towards your goals. As an organization, we keep growing - and so will you. **Our Total Rewards Package** Our Total Rewards package reflects the investments we make in our colleagues to help them and their families achieve their financial, physical and mental well-being goals. Total Rewards at TD includes base salary and variable compensation/incentive awards (e.g., eligibility for cash and/or equity incentive awards, generally through participation in an incentive plan) and several other key plans such as health and well-being benefits, savings and retirement programs, paid time off (including Vacation PTO, Flex PTO, and Holiday PTO), banking benefits and discounts, career development, and reward and recognition. Learn more (*************************************** **Additional Information:** We're delighted that you're considering building a career with TD. Through regular development conversations, training programs, and a competitive benefits plan, we're committed to providing the support our colleagues need to thrive both at work and at home. **Colleague Development** If you're interested in a specific career path or are looking to build certain skills, we want to help you succeed. You'll have regular career, development, and performance conversations with your manager, as well as access to an online learning platform and a variety of mentoring programs to help you unlock future opportunities. Whether you have a passion for helping customers and want to expand your experience, or you want to coach and inspire your colleagues, there are many different career paths within our organization at TD - and we're committed to helping you identify opportunities that support your goals. **Training & Onboarding** We will provide training and onboarding sessions to ensure that you've got everything you need to succeed in your new role. **Interview Process** We'll reach out to candidates of interest to schedule an interview. We do our best to communicate outcomes to all applicants by email or phone call. **Accommodation** TD Bank 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, age, disability, status as a protected veteran or any other characteristic protected under applicable federal, state, or local law. If you are an applicant with a disability and need accommodations to complete the application process, please email TD Bank US Workplace Accommodations Program at *************** . Include your full name, best way to reach you and the accommodation needed to assist you with the applicant process. Federal law prohibits job discrimination based on race, color, sex, sexual orientation, gender identity, national origin, religion, age, equal pay, disability and genetic information.

Toggle accordion tab Primary Purpose Ferrum College seeks impartial, experienced On-Call Investigators to conduct timely, thorough, and objective investigations into alleged violations of College policies, including Title IX, harassment, discrimination, and workplace misconduct. These positions exclude investigations under the Student Code of Conduct, which are managed by the Division of Student Affairs, though collaboration with that office may be required. On-call investigators report directly to the Title IX Coordinator and work in close coordination with the College's General Counsel and Office of Human Resources, depending on the nature of the complaint. This is an as-needed, hourly position based on institutional caseloads. Key Responsibilities * Conduct prompt, impartial investigations into complaints involving Title IX, discrimination, harassment, and other policy violations (excluding Student Code of Conduct cases). * Interview complainants, respondents, and witnesses in a respectful, trauma-informed, and procedurally sound manner. * Gather, analyze, and organize relevant documentation and evidence. * Ensure compliance with federal and state regulations, institutional policies, and due process protections throughout the investigation process. * Maintain accurate and comprehensive records of interviews, evidence, communications, and findings. * Prepare well-written, thorough investigation reports detailing timelines, evidence, and factual findings. * Maintain strict neutrality and avoid conflicts of interest. * Participate in trainings related to Title IX, civil rights, FERPA, and trauma-informed practices as required. * Collaborate as needed with the Offices of Human Resources, General Counsel, and Student Affairs to ensure institutional coordination. * Maintain confidentiality and professionalism in all aspects of the work. Minimum Qualifications * Bachelor's degree from an accredited institution. * Relevant investigative experience in law, compliance, human resources, higher education, or a related field. * Working knowledge of Title IX, civil rights law, and investigatory best practices. * Strong writing, documentation, and interpersonal skills. * Commitment to neutrality, due process, and confidentiality. * Must complete a background check. Preferred Qualifications * Master's degree or J.D. in Law, Higher Education, Human Resources, Criminal Justice, or related field. * Title IX Investigator Certification or similar professional training. * Experience conducting investigations in a college/university setting. * Familiarity with FERPA, VAWA, Clery Act, and other federal compliance requirements. Additional Information * This is a part-time, on-call position with hours determined by the institution's needs. * Investigators may work remotely or on-site, depending on the specific case and institutional needs. * Ferrum College is committed to fostering a safe and respectful environment and encourages applicants who reflect the communities we serve. Other Preferences: Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Ferrum, we are committed to creating a diverse, inclusive, and authentic workplace. If you are excited about this role but your experience doesn't perfectly align with every qualification in the job description, we encourage you to apply anyway. You may be the ideal candidate for this role or other positions on campus. Interested candidates should submit a resume along with the names and telephone numbers of three references to ****************** or mail to Human Resources, Ferrum College, P.O. Box 1000, Ferrum, VA 24088. Background check required. This institution is an equal opportunity provider and employer. All applicants must complete the online Ferrum College Employment Application by clicking here.