Insurance investigator Jobs in Lynn, MA

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Insurance investigator • lynn ma

Last updated: 12 hours ago

Healthcare Fraud Investigator

Contact Government ServicesBoston, MA, United States

Full-time

Employment Type: Full-Time, Mid-Level.CGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN.The candidate must take the initiative ... Show more

Investigator

Commonwealth of MassachusettsBoston, Massachusetts

Full-time

GENERAL STATEMENT OF DUTIES AND RESPONSIBILITIES.Conducts criminal investigations as assigned by the Assistant Deputy Superintendent (ADS) of SID.Works with other law enforcement agencies as needed... Show more

Fraud Investigator

Beacon BankBoston, MA, United States

Full-time

As a member of the Financial Intelligence Unit's Fraud Investigations Team, the incumbent is responsible for handling all aspects of the fraud investigation process including incident intake, advi... Show more

Principal Investigator, Quantum Error Correction

RiverlaneBoston, MA, United States

$180,000.00 yearly

Full-time +1

Principal Investigator, Quantum Error Correction.Boston, MA, US | Full-time | Permanent | Hybrid Salary: $180,000 to $245,000 DOE.The salary range for this role is broad, as we are able to consider... Show more

Remote Physics Expert (Professor / Principal Investigator)

Micro1Beverly, Massachusetts, US

$80.00 hourly

Remote

Full-time

Physics Expert (Professor / Principal Investigator).Expert Judgment in Ambiguous Cases.Defensible Written Articulation.AI data lab for training frontier models and evaluating AI agents.Experts cont... Show more

Senior Associate, Insurance Tax

KPMGBoston, MA, US

Full-time

At KPMG, you can become an integral part of a dynamic team at one of the worlds top tax firms.Enjoy a collaborative, future-forward culture that empowers your success.Work with KPMGs extensive netw... Show more

Undercover Investigator

DATA QUEST INVESTIGATIONS LTDBEVERLY, MA, US

$32.00 hourly

Full-time

Corporate private investigations agency seeks contract Private Investigator to work undercover at a North Shore assignment in warehouse & distribution.Ideal opportunity for Criminal Justice stu... Show more

CIVIL RIGHTS INVESTIGATOR, OGC Equal Opportunity

Boston UniversityBOSTON, MA, US

Full-time

The Equal Opportunity Office (EOO) is committed to fostering an inclusive campus environment free from discrimination, harassment, and sexual misconduct.In support of this mission, we're seeking a ... Show more

Remote Physics Expert (Professor / Principal Investigator)

Micro1Peabody, Massachusetts, US

$80.00 hourly

Remote

Full-time

Associate Investigator

Tufts UniversityMedford, MA, United States

$67,200.00 yearly

Full-time

The Office of Equal Opportunity (OEO) is guided by the University's commitment to create and maintain an academic and work environment where its diverse population of students, faculty and staff ca... Show more

SIU Fraud Investigator

8925 Mass General Brigham Health Plan Holding Company, Inc.MA,Somerville

$79,560.00 yearly

Full-time

Site: Mass General Brigham Health Plan Holding Company, Inc.Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and ... Show more

Remote Physics Expert (Professor / Principal Investigator)

Micro1Chelsea, Massachusetts, US

$80.00 hourly

Remote

Full-time

Remote Physics Expert (Professor / Principal Investigator)

Micro1Salem, Massachusetts, US

$80.00 hourly

Remote

Full-time

Surveillane Investigator

Lemieux & Associates LLCBoston, MA, USA

$25.00 hourly

Part-time

Quick Apply

Ready to put your surveillance skills to work for a national leader?.Our leadership team brings over 25 years of field experience and is committed to fostering a professional, results-driven enviro... Show more

SIU Fraud Investigator

Mass General BrighamSomerville, MA, United States

$79,560.00 yearly

Full-time

Mass General Brigham Health Plan Data Analyst.Mass General Brigham Health Plan is an exciting place to be within the healthcare industry.As a member of Mass General Brigham, we are at the forefront... Show more

Entry-Level Investigator

Ethos Risk ServicesBoston, MA, USA

$22.00 hourly

Full-time

Quick Apply

Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection.At the forefront of, we provide accurate data and ac... Show more

Clinical Investigator, Breast Oncology

The Employee ConnectBoston, Massachusetts, United States

Full-time

Quick Apply

Clinical Investigator, Breast Oncology.Salary Range: $255,670 to $534,220 per year.We are seeking an exceptional Clinical Investigator specializing in Breast Oncology to join a leading academic med... Show more

Employment Investigator

Commonwealth of MassachusettsBoston, Massachusetts

Full-time +1

Compliance Officer I- Employment Investigator.The Massachusetts Commission Against Discrimination (MCAD) is the independent state agency that enforces Massachusetts anti-discrimination laws by inve... Show more

Remote Physics Expert (Professor / Principal Investigator)

Micro1Everett, Massachusetts, US

$80.00 hourly

Remote

Full-time

Healthcare Fraud Investigator

Contact Government ServicesBoston, MA, United States

7 days ago

Job type

Full-time

Job description

Healthcare Fraud Investigator

Employment Type: Full-Time, Mid-Level

CGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client.

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.

Responsibilities Will Include:

Review, sort, and analyze data using computer software programs such as Microsoft Excel.
Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.).
Develop HCF case referrals including, but not limited to:

Ensure that HCF referrals meet agency and USAO standards for litigation.
Analyze data for evidence of fraud, waste and abuse.
Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence.
Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings.
Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc.
Assist conducting witness interviews and preparing written summaries.

Qualifications:

Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field.
Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.
Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.
Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data).
Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy.
U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.
Experience and expertise in performing the requisite services in Section 3.
Must be a US Citizen.
Must be able to obtain a favorably adjudicated Public Trust Clearance.

#CJ

$85,000 - $105,000 a year