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Investigator
1 week ago
DiPasquale Moore Saint Louis, United StatesJob Description · Job DescriptionTITLE: Investigator · REPORTS TO: Intake Director · COMPENSATION: Competitive salary commensurate with experience · POSITION TYPE: Exempt · REQUIREMENTS: · (3) or more years of investigative work or similar experience · Previous experience in law ...
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Investigator
2 days ago
DiPasquale Moore St Louis, United StatesJob Description Job Description TITLE: InvestigatorREPORTS TO: Intake DirectorCOMPENSATION: Competitive salary commensurate with experiencePOSITION TYPE: ExemptREQUIREMENTS:(3) or more years of investigative work or similar experiencePrevious experience in law enforcement is very ...
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Surveillance Investigator
4 days ago
Allied Universal St. Louis, United States Part timeJob Description · Allied Universal is hiring a Surveillance Investigator. Surveillance Investigators perform discreet mobile and stationary surveillance of Claimant to confirm current activities and capabilities to assist with the administration of an Insurance claim. · Remote wo ...
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Surveillance Investigator
2 days ago
Frasco Inc St. Louis, United States:ABOUT US: Frasco Investigative Services, a division of Frasco, Inc., provides unparalleled quality surveillance investigations throughout the entire United States. Frasco is a full-service investigation corporation serving the insurance, legal, employment, and entertainment comm ...
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Deviation Investigator
2 weeks ago
Katalyst HealthCares & Life Sciences St. Louis, United StatesResponsibilities: Assume site level responsibility for all major investigations including items originating from Production, Quality Control, Facilities, etc. · Coach and drive root cause analysis (RCA) · Facilitate cross functional teams to evaluate causal factors. · Provide ...
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Surveillance Investigator
2 weeks ago
Allied Universal St. Louis, United States Part timeJob Description · Allied Universal is hiring a Surveillance Investigator. Surveillance Investigators perform discreet mobile and stationary surveillance of Claimant to confirm current activities and capabilities to assist with the administration of an Insurance claim. · Remote wo ...
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Deviation Investigator
3 weeks ago
Intelliswift Software St Louis, United StatesJob Description · Title: Deviation Investigator · Duration: 6 Months on W2 · Location: St. Louis, MO · Details: · Assume site level responsibility for all major investigations including items originating from Production, Quality Control, Facilities, etc. · • Coach and drive root ...
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Private Investigator
2 weeks ago
Lemieux & Associates LLC Saint Louis, United StatesJob Description · Job DescriptionCome grow with us Lemieux & Associates, a national leader in the investigative industry, is seeking experienced surveillance Field Investigators in the St. Louis or surrounding area. This is a part-time position to start with the ability to turn i ...
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Private Investigator
2 weeks ago
Lemieux & Associates LLC Saint Louis, United StatesJob Description · Job DescriptionCome grow with us Lemieux & Associates, a national leader in the investigative industry, is seeking experienced Field Investigators in the St. Louis, MO or surrounding area. This is a part-time position to start with the ability to turn into a ful ...
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SIU Investigator
2 weeks ago
Advantage Surveillance LLC Saint Louis, United States Part timeJob Description · Job DescriptionAdvantage Investigations is the region's only insurance defense investigation firm that invests in the operational capabilities necessary to produce consistent, high-quality results—ultimately helping our clients "See What's True." Our company use ...
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Background Investigator I
1 week ago
CACI St. Louis, United StatesBackground Investigator IJob Category: Service Contract ActTime Type: Part timeMinimum Clearance Required to Start: Top SecretEmployee Type: Part-Time On-CallPercentage of Travel Required: Up to 25%Type of Travel: Continental US* * *At CACI, background investigation is more than ...
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Investigator
5 days ago
DiPasquale Moore St Louis, United StatesTITLE: · Investigator · REPORTS TO: · Intake Director · COMPENSATION: · Competitive salary commensurate with experience · POSITION TYPE: · Exempt · REQUIREMENTS: · (3) or more years of investigative work or similar experience · Previous experience in law enforcement is very u ...
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Investigator
1 week ago
DiPasquale Moore Saint Louis, United StatesJob Description · Job DescriptionTITLE: Investigator · REPORTS TO: Intake Director · COMPENSATION: Competitive salary commensurate with experience · POSITION TYPE: Exempt · REQUIREMENTS: · (3) or more years of investigative work or similar experience · Previous experience in law ...
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Background Investigator I
2 days ago
CACi St Louis, United StatesBackground Investigator IJob Category: Service Contract ActTime Type: Part timeMinimum Clearance Required to Start: Top SecretEmployee Type: Part-Time On-CallPercentage of Travel Required: Up to 25%Type of Travel: Continental US* * * At CACI, background investigation is more than ...
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Special Investigations Unit
5 days ago
Ethos Risk Services Saint Louis, United StatesJob Description · Job DescriptionEthos is looking to hire a part time, experienced Insurance SIU / Claims Field Investigator in the Saint Louis, MO area. · JOB DESCRIPTION: · We are looking for qualified candidates to join our growing team of professionals. We are Looking for P/T ...
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Special Investigations Unit
1 day ago
Ethos Risk Services St Louis, United StatesJob Description Job Description Ethos is looking to hire a part time, experienced Insurance SIU / Claims Field Investigator in the Saint Louis, MO area.JOB DESCRIPTION:We are looking for qualified candidates to join our growing team of professionals. We are Looking for P/T employ ...
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Credentialed Field Investigator
2 days ago
Paragon Security Systems St Louis, United StatesParagon Investigations sector is procuring credentialed 1099 Independent Contractor Field Investigators for work on the DCSA contract in St. Louis, MO. We provide orientation, materials, and support on this contract, along with a localized dedicated point of contact and competiti ...
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Special Investigations Unit
2 days ago
Ethos Risk Services St Louis, United StatesJob Description · Job Description · Ethos is looking to hire a part time, experienced Insurance SIU / Claims Field Investigator in the · Saint Louis, MO · area. · JOB DESCRIPTION: · We are looking for qualified candidates to join our growing team of professionals. We are Look ...
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Background Investigator I
1 day ago
CACi St Louis, United StatesBackground Investigator IJob Category: Service Contract ActTime Type: Part timeMinimum Clearance Required to Start: Top SecretEmployee Type: Part-Time On-CallPercentage of Travel Required: Up to 25%Type of Travel: Continental US* * * At CACI, background investigation is more than ...
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Credentialed Field Investigator
2 weeks ago
Paragon Security Systems St Louis, United StatesParagon Investigations sector is procuring credentialed 1099 Independent Contractor Field Investigators for work on the DCSA and DHS contracts in St. Louis, MO. We provide orientation, materials, and support on these contracts, along with a localized dedicated point of contact an ...
Investigator II - St Louis, United States - Elevance Health
Description
Investigator IILocation :
This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
The INVESTIGATOR II is responsible for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims.
How you will make an impact:
Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims.
Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health plan, line of business and/or state.
Effectively establish rapport and on-going working relationship with law enforcement.May interface internally with Senior level management and legal department throughout investigative process.
May assist in training of internal and external entities.
Assists in the development of policy and/or procedures to prevent loss of company assets.
Minimum Requirements:
Requires a BA/BS and minimum of 3 years related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences :
Fraud certification from CFE, AHFI, AAPC or coding certificates preferred.
Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred.
Health insurance, law enforcement experience preferred.#J-18808-Ljbffr