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Investigator Salary in USA

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Investigator Salary in USA

1 500 $ Average monthly salary

Average salary in the last 12 months: "Investigator in USA"

Currency: USD Year: 2024
The bar chart shows the change in the level of average salary of the profession Investigator in USA.

Distribution of vacancy "Investigator" by regions USA

Currency: USD
As you can see on the diagramm in USA the most numerous number of vacancies of Investigator Job are opened in Pennsylvania. In the second place is Massachusetts, In the third is Illinois.

Regions rating USA by salary for the profession "Investigator"

Currency: USD
As you can see on the diagramm in USA the most numerous number of vacancies of Investigator Job are opened in Pennsylvania. In the second place is Massachusetts, In the third is Illinois.

Similar vacancies rating by salary in USA

Currency: USD
As you can see on the diagramm in USA the most numerous number of vacancies of Investigator Job are opened in Pennsylvania. In the second place is Massachusetts, In the third is Illinois.

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Investigator II
Brigham & Women's Hospital(BWH), Boston
GENERAL SUMMARY/ OVERVIEW STATEMENT: Summarize the nature and level of work performed.Under the general supervision of the Investigator III, conducts felony andmisdemeanor investigations both internal and external. Apply for criminal complaints, arrest warrants and search warrants in compliance with 515 CMR 5.07 (1), (2). Ideal candidate will have a history of work experience demonstrating progressive growth, leadership and responsibility. A Law Enforcement background preferred. Preferred candidates will be a certified police officer in the state of Massachusetts and have the ability to become a Massachusetts Special State Police Officer (SSPO). PRINCIPAL DUTIES AND RESPONSIBILITIES: Indicate key areas of responsibility, major job duties, special projects and key objectives for this position. These items should be evaluated throughout the year and included in the written annual evaluation.• Performs a variety of work activities related to investigative assignments including follow-up investigations of crime and other incidents as well as conducting surveillance of areas of suspected or potential criminal activity. • Responds to the scene of crimes; searches for, preserves and collects evidence; investigates and interviews victims, witnesses, and potential suspects; conducts appropriate investigative functions such as photographing and other investigative initiatives at the crime scene. • Participate in assisting victims of workplace violence or domestic violence by facilitating service of restraining/protective orders when necessary. • Render assistance with protection of notable persons and assist with VIP patients and their security teams. Performs Executive Protection duties as needed. • Operates emergency vehicles as needed. • Make presentations as requested.• Performs all duties inclusive of Investigator I as needed.• Conducts unbiased investigations into any allegations of criminal activity or violations of hospital policy that occur on or about Hospital property.• Conducts follow-up interviews with victims of criminal activity to assist with all aspects of an investigation. Maintains written documentation and case files of all activity. • Construct and disseminate security alerts (BOLO) for the benefit of police and security personnel.• Acts as an investigative liaison with outside law enforcement.• Perform any and all duties required and assigned by a supervisor.• Supports and assists outside law enforcement agencies with inquiries and reviews, associated with BWH.• Supports and assists, when appropriate, with court appearances for BWH personnel.• Supports and assists Pharmacy, Nursing and Human Resources in conducting investigations into narcotics diversions. The duty of the investigator is to prevent, detect and investigate instances of diversion.• Conducts threat assessments, safety audits and risk screening/assessments. Documents these for action by management.• Track crime trends and patterns of criminal activity. 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Conducts FBI criminal background checks as part of this process.• Compile crime statistics and generate monthly, quarterly and annual reports.• Serve as liaison to Domestic Violence and SAFE committees.• Conducts Background Investigations for security officers and SSPO's as needed.Qualifications QUALIFICATIONS: (MUST be realistic, neither overstated nor understated, and related to the essential functions of the job.)• Ability to obtain and subsequently maintain license as a Special State Police Officer under MGL 22c Section 63, within 90days, required.• An Associate degree in criminal justice or related field, from accredited college or university required. Bachelor degree preferred.• The incumbent may meet the minimum training requirements to be licensed as a Special State Police Officer and complete all MPTC In-Service training as required.• Must be a graduate of the Municipal Police Training Committee Police Academy or equivalent police academy as described in 515 CMR 5.00, and the Massachusetts State Police Certification Unit. • Must obtain and maintain required certification in the following programs (training provided through the department).• First Responder/CPR• AVADE 1,2,3 Training• Demonstrated proficiency with gathering information or securing evidence for the arrest of persons alleged to have committed felonies or misdemeanors.• Demonstrated proficiency of interviewing suspects, prisoners, complainants and witnesses to obtain information about crimes.• Demonstrated ability to supervise and instruct other officers in crime scene security procedures.• Demonstrated ability to work with fellow officers, and local, state and federal law enforcement agencies.SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: (MUST be realistic, neither overstated nor understated, and related to the essential functions of the job.)• Exemplary customer service and communication skills. Must be able to handle complex interpersonal situations and crisis management scenarios.• Strong risk analysis and organizational skills.• Reliable and flexible.• Available to respond off-hours as needed.• Must be able to prepare clear and concise reports and routine correspondence.• Operate office equipment including computers and supporting word processing, spreadsheet, and database applications.• Must be able to read, write and speak English fluently. Fluency in more than one language preferred.PHYSICAL REQUIREMENT: (MUST be realistic, neither overstated nor understated, and related to the essential functions of the job.)- Physically must be able to lift 50 pounds. Ability to stand/walk for a minimum of 8 hours. Ability to run to any emergency within the hospital and adjoining campuses and be able to verbally and physically control an emergency situation upon arrival if necessary. 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Investigator/Biostatistician
Brigham & Women's Hospital(BWH), Boston
GENERAL SUMMARY/ OVERVIEW STATEMENT: The Center for Clinical Investigation (CCI) is designed to provide infrastructure support to the investigative community, leading to a more effective and robust clinical research enterprise at Brigham and Women's Hospital. This position involves project management for the statistical analyses and programming of clinical trials from small investigator initiated studies to large scale international clinical trials. For the projects in which the successful candidate participates, the person will become an integral part of the research team from research development to protocol design to pre-designed statistical plan to analyses to manuscript preparation. Qualified candidates will have advanced formal training in statistics or biostatistics including design and analysis of observational and experimental studies, and strong statistical computing skills. 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Investigator I
Elevance Health, Woodland Hills
Description Investigator I Schedule: 1-2 days per week in the office (Hybrid 1) Location: This position will work on claims in either California or Nevada in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. The Investigator I position is responsible for investigating assigned cases, collecting, researching and analyzing claim data in order to detect fraudulent, abusive or wasteful activities/practices. This is how you will make an impact: Using appropriate system tools and databases for analysis of data and review of professional and facility claims to detect fraudulent, abusive or wasteful healthcare insurance payments to providers and subscribers. Review of medical records to include progress notes, treatment plans, and other documentation required to support billed services. Review and interpretation of regulations, provider handbooks, and other regulatory documentation. 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Investigator, Incident Reporting
Lone Star College, Houston
Job Title: Investigator, Incident Reporting Location: LSC-System Office Regular/Temporary: Regular Full/Part Time: Full-Time Job ID: 40901 Commitment to Mission This job carries with it the obligation to uphold the Mission of Lone Star College (LSC) in carrying out the duties of the position. 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Investigator II
Biogen, Research Triangle Park
Job DescriptionAbout This RoleThis site-based role supports MFG, primarily during core weekday business hours, but may require off-hours support.The Investigator II is responsible for maximizing organizational learning and improvement from Quality deviations. This team applies systematic and analytical cause analysis techniques in direct support of manufacturing operations. The Investigator II applies appropriate methodology for each given situation, facilitates investigation team meetings, conducts interviews, collects data, and synthesizes data to identify causes and casual factors. The Investigator II will support major & critical deviations, collaborating with the Learning Teams to support corrective actions.What You'll DoLeads investigations for Quality deviations and incidents as required. 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Together, we thrive.At Biogen, we are committed to building on our culture of inclusion and belonging that reflects the communities where we operate and the patients we serve. We know that diverse backgrounds, cultures, and perspectives make us a stronger and more innovative company, and we are focused on building teams where every employee feels empowered and inspired. Read on to learn more about our DE&I efforts.All qualified applicants will receive consideration for employment without regard to sex, gender identity or expression, sexual orientation, marital status, race, color, national origin, ancestry, ethnicity, religion, age, veteran status, disability, genetic information or any other basis protected by federal, state or local law. Biogen is an E-Verify Employer in the United States.PDN-9ba72efc-1904-48a7-9872-d144f32735b7
Investigator, MRTS-Reporting & Disclosure
FINRA., Rockville
The Principal Investigator conducts comprehensive and timely investigations, including matters of various sizes and levels of complexity, where there is cause to believe violations exist of applicable rules and securities laws, under FINRA or Regulatory Service Agreement (RSA) jurisdiction, related to securities market regulation. The Principal Investigator mentors and coaches more junior staff in the completion of their investigations.Essential Job Functions:Conducts comprehensive investigations of possible violations of rules and federal securities laws with moderate supervision.  Researches and provides management with updates regarding rules, regulations, guidelines, intelligence, advisories, material regulatory and law enforcement cases, records, and databases. Conducts testing and participates in developing new analytics, investigative tools or processes that detect and deter violative activity, while maintaining and enhancing investigative methods and developing improved approaches for uncovering violations. Responsible for evidence gathering through verbal and written correspondence, including on-the-record testimony, with registered and associated persons, investors, company management, member and RSA non-member firms, and others. Develops actionable insights for appropriate investigative responses to emerging regulatory risks and threats. Responsible for the documentation of strategies, investigative steps, and investigative results, including referrals to Enforcement and outside agencies. Mentors and coaches more junior colleagues in techniques, processes and responsibilities. Demonstrates a culture of FINRA’s values of Responsibility, Innovation, Collaboration and Expertise, while embracing FINRA’s culture of diversity and inclusion, in interactions with colleagues, management, FINRA members, and outside parties.Other Responsibilities:Participates in special projects, surveys, committee assignments, and technology initiatives impacting the relevant team. Education & Experience Requirements:Bachelor’s degree and a minimum seven (7) years of experience in the securities/financial services industry required with knowledge of regulatory compliance, or an equivalent combination of education and experience.  Clear and convincing demonstration that investigative, organizational and decision-making capabilities are highly proficient.  Demonstrated ability to independently initiate, strategize and complete complex investigations.Demonstrated ability to work closely with management to develop policies and goals that maximize the resources of Market Regulation.Demonstrated ability to accomplish specific Market Investigations mission and goals through excellent performance on special departmental projects.Demonstrated ability to anticipate and serve internal/external customer needs. Demonstrated excellent communication skills. Working Conditions:This is a hybrid position, with office attendance expected as deemed necessary.Some travel may be requiredFor work that is performed in CA, Washington, DC, CO, HI, New York, NY and WA, the chart below outlines the proposed salary range for the corresponding location. In addition to location, actual compensation is based on various factors, including but not limited to, the candidate’s skill set, level of experience, education, and internal peer compensation comparisons.California: Minimum Salary $106,400, Maximum Salary $200,200Washington, DC: Minimum Salary $106,400 Maximum Salary $191,800Colorado/Hawaii: Minimum Salary $92,500, Maximum Salary $166,800New York, NY: Minimum Salary $111,000, Maximum Salary $200,200Washington State: Minimum Salary $92,500, Maximum Salary $191,800#LI-Hybrid To be considered for this position, please submit an application. Applications are accepted on an ongoing basis.The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities and qualifications required.Please note: If the “Apply Now” button on a job board posting does not take you directly to the FINRA Careers site, enter www.finra.org/careers into your browser to reach our site directly.FINRA strives to make our career site accessible to all users. If you need a disability-related accommodation for completing the application process, please contact FINRA's Employee Relations team at 240.386.4865 or by email at [email protected]. Please note that this process is exclusively for inquiries regarding application accommodations. Employees may be eligible for a discretionary bonus in addition to base pay. FINRA provides comprehensive health, dental and vision insurance.  Additional insurance includes basic life, accidental death and dismemberment, supplemental life, spouse/domestic partner and dependent life, and spouse/domestic partner and dependent accidental death and dismemberment, short- and long-term disability, long-term care, business travel accident, disability and legal.  FINRA offers immediate participation and vesting in a 401(k) plan with company match and eligibility for participation in an additional FINRA-funded retirement contribution, tuition reimbursement and many other benefits. Time Off and Paid Leave*FINRA encourages its employees to focus on their health and wellness in many ways, including through a generous time-off program of 15 days of paid time off, 5 personal days and 9 sick days (all pro-rated in the first year). Additionally, we are proud to support our communities by providing two volunteer service days (based on full-time schedule). Other paid leave includes military leave, jury duty leave, bereavement leave, voting and election official leave for federal, state or local primary and general elections, care of a family member leave (available after 90 days of employment); and childbirth and parental leave (available after 90 days of employment). Full-time employees receive nine paid holidays.*Based on full-time scheduleImportant InformationFINRA’s Code of Conduct imposes restrictions on employees’ investments and requires financial disclosures that are uniquely related to our role as a securities regulator. FINRA employees are required to disclose to FINRA all brokerage accounts that they maintain, and those in which they control trading or have a financial interest (including any trust account of which they are a trustee or beneficiary and all accounts of a spouse, domestic partner or minor child who lives with the employee) and to authorize their broker-dealers to provide FINRA with duplicate statements for all of those accounts. All of those accounts are subject to the Code’s investment and securities account restrictions, and new employees must comply with those investment restrictions—including disposing of any security issued by a company on FINRA’s Prohibited Company List or obtaining a written waiver from their Executive Vice President—by the date they begin employment with FINRA. Employees may only maintain securities accounts that must be disclosed to FINRA at one or more securities firms that provide an electronic feed (e-feed) of data to FINRA, and must move securities accounts from other securities firms to a firm that provides an e-feed within three months of beginning employment.You can read more about these restrictions here.As standard practice, employees must also execute FINRA’s Employee Confidentiality and Invention Assignment Agreement without qualification or modification and comply with the company’s policy on nepotism.Search Firm RepresentativesPlease be advised that FINRA is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, a valid written agreement and task order must be in place before any resumes are submitted to FINRA. All resumes submitted by search firms to any employee at FINRA without a valid written agreement and task order in place will be deemed the sole property of FINRA and no fee will be paid in the event that person is hired by FINRA.FINRA is an Equal Opportunity and Affirmative Action EmployerAll qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person’s relatives, friends or associates.FINRA abides by the requirements of 41 CFR 60-741.5(a). This regulation prohibits discrimination against qualified individuals on the basis of disability, and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.FINRA abides by the requirements of 41 CFR 60-300.5(a). This regulation prohibits discrimination against qualified protected veterans, and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans.2020 FINRA. All rights reserved. FINRA is a registered trademark of the Financial Industry Regulatory Authority, Inc.
Investigator II
Elevance Health, Atlanta
Description Investigator II Supporting the Payment Integrity line of business Location: 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. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Investigator 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 Qualifications: 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. Experience with Excel spreadsheets highly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance.
Investigator Senior
Elevance Health, woodland hills
Description Investigator Senior This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Investigator Senior is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims. 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 independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one company health plan, line of business and/or state. May interface internally with Senior level management and legal department throughout investigative process. May assist in training of internal and external entities. Assists in the development of policy and/or procedures to prevent loss of company assets. May be called upon to represent the Company in court proceedings regarding research findings. Health insurance experience required with understanding of health insurance policies, health insurance claims handling and provider network contracting. Develops and maintains a high degree of rapport and cooperation with the Federal, State and local law enforcement and regulatory agencies which can assist in investigative efforts. Minimum Requirements: Requires a BA/BS and minimum of 5 years related experience in healthcare insurance and healthcare insurance investigation, law enforcement; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job related designation preferred. Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred. Excel knowlege a plus. Experience within Managed Care Organization a plus. For candidates working in person or remotely in the below locations, the salary* range for this specific position is $73,360 to $132,048 Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws . * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance.
Investigator Assistant
Elevance Health, Atlanta
Description Investigator Assistant Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Investigator Assistant is responsible for providing administrative support to the investigative unit and performing research on data to assist in identifying cases of potential overpayment or abuse. How you will make an impact: Collects, researches, and validates bills and claims data against relevant guidelines. Assists in preparation of statistical and financial analysis reports. Requests medical records and additional documentation required for investigation. Completes initial file set-up and tracks cases. Processes and tracks all incoming reimbursement checks. Assists in managing fraud hotline calls. Provides administrative support for investigative management and staff. Minimum Requirements: Requires a HS diploma or equivalent and minimum of 1 year experience; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: Bachelor's Degree preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance.
Investigator II - Medicaid (Iowa)
Elevance Health, West Des Moines
Description Investigator II Schedule : 1-2 days per week in the office (Hybrid 1) Location: This position will work a hybrid model (remote and office). The candidate must live within 50 miles of our Elevance Health PulsePoint location in West Des Moine, Iowa (in Iowa). The Investigator II position 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. Intermediate knowledge of Microsoft Excel. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance.