Trabajos fraud investigator en Bayonne, New JerseyCrear alertas

Position summary Reed Smith Legal Solutions is seeking a highly experienced and strategic Manager, to join their Intelligence & Investigations team to lead complex investigative engagements and deliver actionable intelligence to clients across the legal, financial services, and corporate sectors. This role is ideal for a seasoned investigator and research professional with deep expertise in OSINT methodologies, investigative strategy, and global intelligence gathering. The successful candidate will play a central role in executing high-impact client matters, managing investigative workflows, and mentoring research personnel and subcontractors across multiple jurisdictions. The Manager will work closely with internal stakeholders and cross-functional teams to deliver innovative, technology-enabled investigative solutions. While this position is not primarily sales-focused, the role requires strong relationship management skills and the ability to serve as a trusted ambassador for Reed Smith Legal Solutions internally and externally. Job duties and responsibilities Lead and execute complex investigative and intelligence engagements utilizing advanced OSINT and HUMINT methodologies. Conduct and oversee investigations related to: Asset tracing Fraud and financial crime investigations Counterparty and reputational due diligence Ultimate Beneficial Ownership (UBO) identification Evidence collection and fact-finding Sanctions and compliance-related investigations Opposition and litigation support research Manage and mentor junior researchers, analysts, and subcontractors across domestic and international jurisdictions. Drive innovation in investigative practices by identifying and implementing emerging OSINT tools, technologies, and research techniques. Partner with internal AI and technology teams to identify efficiencies and enhancements across the investigative lifecycle through Generative AI and automation solutions. Oversee and maintain global investigative databases, research resources, and third-party intelligence networks. Collaborate closely with legal, risk, compliance, and business stakeholders to provide integrated and differentiated client solutions. Build strong internal relationships and act as a visible ambassador for Reed Smith Legal Solutions across practices and geographies. Ensure high-quality deliverables, project management discipline, and adherence to client timelines and expectations. Job duties and responsibilities included are not exhaustive and may be supplemented asnecessary. Reed Smith reserves the right to revise or modify job duties and responsibilities at any time. Requirements Education: Bachelor's degree in Computer Science, Computer Forensics, Cybersecurity, or related field. Experience: 10+ years of experience in corporate intelligence, investigations, consulting, law enforcement, government intelligence, legal services, opposition research, or related fields. International work or living experience; multilingual capabilities are strongly preferred. Experience supporting M&A transactions, corporate development initiatives, or transactional due diligence projects. Familiarity with AI-enabled investigative workflows and emerging technologies supporting intelligence operations. Experience developing or implementing AI-driven solutions to improve investigative efficiency, scalability, and accuracy. Skills: Demonstrated success conducting sophisticated investigative work and delivering actionable intelligence to clients or senior stakeholders. Strong understanding of the U.S. legal and court systems, including federal, state, and local court structures and publicly available records. Deep expertise in OSINT research methodologies, investigative databases, and digital intelligence techniques. Experience managing investigative teams, researchers, and third-party vendors across multiple geographies. Strong analytical, problem-solving, and critical-thinking capabilities with the ability to work independently in fast-paced environments. Exceptional written and verbal communication skills, including experience interfacing directly with clients, attorneys, executives, and cross-functional stakeholders. Proven ability to manage multiple priorities and complex projects simultaneously. Additional information Supervisory responsibilities: None. Equipment used: Personal computer and other office equipment such as telephone, calculator, copier, scanner, etc. Essential job functions Ability to sit or stand for extended periods and perform tasks requiring prolonged and/or extensive computer use. Ability to use computers, telecommunications, and digital collaboration tools to perform core job responsibilities. Ability to communicate effectively. Ability to maintain attention to detail while analyzing complex information, managing multiple priorities, and applying sound judgment to strategic decisions. Ability to access, use, and safeguard confidential and sensitive information while performing job responsibilities in work environments that support confidentiality, privacy, and information security requirements. Travel for meetings and training as required. Ability to work extended hours as required to meet project, client, or business needs. Working conditions You will be required to work in the office at minimum 4 days per week. Occasionally called upon to work hours in excess of your normal daily schedule. The details of your weekly schedule will be discussed further with your direct supervisor. Pay ranges This represents the presently anticipated low and high end of Reed Smith's pay range for this position. Actual pay may vary based on various factors, including but not limited to location and experience. $165,000 - $185,000 Employee benefits overview Our comprehensive benefits package includes: 401(k) Retirement Plan Medical Insurance Health Savings Account (HSA) Virtual Health Services Dental Insurance Vision Insurance Accident Insurance Hospital Indemnity Insurance Critical Illness Insurance Life Insurance Short-Term Disability Coverage Long-Term Disability Coverage Flexible Spending Accounts (FSA) Lyra Health Employee Assistance Program (EAP) Paid Family Leave (for eligible Exempt and Non-Exempt staff) Transportation Benefit Back-up Child Care Services College Coach Program Pet Insurance Paid Sick Time (for Exempt staff) Paid Time Off (available to all full-time, non-temporary employees) Reed Smith offers a challenging work environment, business casual dress code and a total compensation package that includes a competitive salary, flexible benefits program, tuition assistance, and generous 401(k) plan. Reed Smith is an Equal Opportunity Employer with Core Values of Integrity, Excellence, Teamwork & Respect, Innovation, and Impact. Reed Smith also provides reasonable accommodations in accordance with law, including in the application and interview process. Qualified candidates only. No search firms.

Full Time, Billable Hours, Non-exempt .Eager to start your career in a growing industry? Get paid to learn the ropes of fraud investigation and real-world surveillance.Frasco offers fully paid investigator training to help you launch your career! .Check out our YouTube channel to learn more

Are you ready to embark on a thrilling adventure in the world of covert surveillance? Team 360 Staffing, on behalf of Meridian Investigative Group, is seeking a Covert Surveillance Investigator to join their dynamic Investigative Team. Your mission, should you choose to accept it, is to uncover the truth behind worker’s compensation fraud with stealth and precision. As their covert sleuth, you'll embark on thrilling field surveillance adventures, blending seamlessly into the shadows to gather evidence. Your toolkit includes stationary and mobile surveillance tactics, capturing high-quality video and photographic proof of subjects in action. Crafting comprehensive investigative reports is just the beginning, you'll be uploading your findings into their cutting-edge case management system, readying them for the next thrilling chapter. Job type: Full-time or Part-time Responsibilities: • Conduct covert field surveillance using both stationary and mobile tactics., • Capture top-notch video and photographic evidence of subjects., • Prepare comprehensive investigative reports based on collected intelligence., • Upload findings into our cutting-edge case management system., • Conduct interviews and recorded statements, extracting key insights., • Provide compelling legal testimony when called upon., • Assist in setting up outside surveillance cameras for our Unmanned department. Requirements: • Excellent communication skills, both verbal and written., • Strong ability to gather, compile, and report data., • Capable of providing legal depositions and testimony., • Expertise in evidence gathering and organization., • Knowledge of legal documentation procedures. License/Certification Requirements: • Valid state-issued driver’s license., • Current auto insurance., • Possess an investigator license in the state of operation. Required Equipment: • Reliable vehicle., • Smartphone with access to the app store (Android OS 7 or higher, Apple iOS 11 or higher)., • Laptop computer with Microsoft Word, Windows, and wireless Internet., • Digital video camera with upload capability and accurate time/date stamp. Working Conditions: • Flexible hours with occasional overnight travel, weekend/evening work, and holiday shifts., • Work both indoors and outdoors, embracing various environments and conditions. Physical Requirements: • Ability to sit, stand, walk, and lift up to 50 pounds., • Sharp vision and focus for extended periods., • Moderate exposure to environmental elements. Benefits for Full-time employees: • Weekly Pay & Expense Reimbursement., • Company-paid PI License Renewal., • Vehicle Allowance & Fuel Card., • Cellphone Reimbursement., • Report Writing Pay & Break-Off Time Pay., • Per Diem & 401K with Employer Matching., • Health, Dental, Vision, & Life Insurance., • Accident & Critical Illness Insurance., • Paid Holidays & Time Off. Ready to uncover the truth while enjoying awesome benefits and perks? Apply now to join their elite team of covert operatives! Employment is subject to a background check.

Who we are: We are a leader in fraud prevention and AML compliance. Our platform uses device intelligence, behavior biometrics, machine learning, and AI to stop fraud before it happens. Today, over 300 banks, retailers, and fintechs worldwide use Sardine to stop identity fraud, payment fraud, account takeovers, and social engineering scams. We have raised $145M from world-class investors, including Andreessen Horowitz, Activant, Visa, Experian, FIS, and Google Ventures. Our culture: We have hubs in the Bay Area, NYC, Austin, Toronto, and São Paulo. However, we maintain a remote-first work culture. #WorkFromAnywhere We hire talented, self-motivated individuals with extreme ownership and high growth orientation. We value performance and not hours worked. We believe you shouldn't have to miss your family dinner, your kid's school play, friends get-together, or doctor's appointments for the sake of adhering to an arbitrary work schedule. Location: Remote - USA/Canada/Brazil From Home / Beach / Mountain / Cafe / Anywhere! We are a remote-first company with a globally distributed team. You can find your productive zone and work from there. About the Role: As a backend-focused Staff Software Engineer, you will own and lead the development of our compliance and financial crime prevention platform. This pivotal role involves designing, building, and maintaining critical systems that power KYC onboarding, sanctions screening, transaction monitoring, and regulatory reporting capabilities. This multifaceted position involves developing new features at scale, driving technical strategy, refining internal tooling and processes, mentoring engineers, and assuming broad ownership across the platform. You will operate as a technical leader with influence beyond your immediate team, partnering with stakeholders across the organization to solve complex problems in a highly regulated domain. The ideal candidate has a proven track record in building highly available APIs, robust data integrations, and leading technical initiatives from conception to delivery. Prior experience in the AML/CFT compliance domain is a plus, but not required. What you’ll be doing: Architect, design, and implement robust, efficient, and reliable backend services for KYC workflows, sanctions screening engines, and alert management systems Build and optimize case management and alert creation pipelines that enable investigators to efficiently review and disposition suspicious activity Develop and maintain integrations with regulatory reporting systems, including SAR filing and GoAML submissions Collaborate closely with compliance stakeholders, product teams, and other engineering teams to translate regulatory requirements into scalable technical solutions Contribute to developing new features and capabilities that enhance detection accuracy, reduce false positives, and streamline investigator workflows Craft and maintain technical documentation for compliance systems, ensuring auditability and facilitating regulatory examinations Play a pivotal role in shaping our company's engineering culture, ensuring the maintenance of high engineering standards across the organization What you’ll need: A minimum of 7 years of proven experience as a Software Engineer specializing in web backend development and complex system integrations A track record of successfully delivering high-quality production services, particularly those involving high-throughput data processing and real-time screening Proficiency in Golang is a significant advantage Proficient in English—from casual chats to formal reports Nice to Have: Experience in regulated industries such as financial services (AML/KYC), healthcare (HIPAA), background screening, payment security (PCI-DSS), or similar compliance-driven environments Familiarity with SAR/STR filing processes and GoAML or similar regulatory reporting formats Experience with case management systems, alert workflows, and investigation tooling Benefits we offer: Generous compensation in cash and equity Early exercise for all options, including pre-vested Work from anywhere: Remote-first Culture Flexible paid time off and Year-end break Health insurance, dental, and vision coverage for employees and dependents - US and Canada specific 4% matching in 401k / RRSP - US and Canada specific MacBook Pro delivered to your door One-time stipend to set up a home office — desk, chair, screen, etc. Monthly meal stipend Monthly social meet-up stipend Annual health and wellness stipend Annual Learning stipend Join a fast-growing company with world-class professionals from around the world. If you are seeking a meaningful career, you found the right place, and we would love to hear from you. To learn more about how we process your personal information and your rights in regards to your personal information as an applicant and Sardine employee, please visit our _.

FSA Federal (FSA) is focused on delivering unsurpassed services in support of law enforcement and homeland security. We currently have a vacancy for a Senior Civil Investigator. In this role, you will be supporting the overall mission of the United States Attorney's Office (USAO), Health Care & Government Fraud Unit (HCGFU). If you are looking for a meaningful, mission driven career, Join FSA! Responsibilities • Plan and conduct investigations to develop and/or verify facts of health care fraud cases and complaints, both independently and in consultation with Assistant U.S. Attorneys who handle health care fraud matters. Major duties include:, • Identifying witnesses and conducting interviews;, • Reviewing documents, reports, bank records, interview files, computer data, and other produced materials, including patient records and health care billing records;, • Assisting attorneys in formulating investigative plans to identify facts and issues involved in a case, the applicable theories of law, and the scope of the investigation;, • Establishing and maintaining an effective system of compiling, indexing, and organizing information and its sources;, • Preparing reports and presenting findings orally and in writing to attorneys and other staff., • Participate and assist in preparation for settlement negotiations and trial. Major duties include:, • Compiling, organizing, and indexing evidence;, • Managing the presentation of exhibits at settlement negotiations and trial, including preparing narrative summaries, charts, tables, graphs, or other visual aids. Requirements, • Bachelor's degree required. Master's preferred. Additional experience can be substituted for advanced degree requirements, • Must have the ability to use MS Excel, MS Outlook, MS Access or other data bases., • Must have a working knowledge of research methods involved in the collection and analysis of data., • Communication and interpersonal skills are extremely important. Must be able to work and interact professionally and effectively with all levels of staff and public., • Must have the ability to meet established deadlines and work as a team player in a professional office. This position requires U.S. Citizenship and a 7 (or 10) year minimum background investigation. Agency Overview The United States Attorney's Office (USAO) serves as the nation's principal litigators under the direction of the Attorney General. The HCGFU engages in civil & criminal enforcement relating to health care fraud matters. In enforcing numerous relevant statutes, the HCGFU pursues cases in many areas, including violations of the False Claims Act and cases against individuals as well as organizations or corporations. Benefits Overview At FSA Federal, we recognize the diverse needs of our employees and strive to provide an excellent package to help meet those needs. Comprehensive benefits are offered with greater choice and flexibility to support your health, work-life balance, and professional growth. A package providing employee only coverage can be built around our basic plans at $0 employee cost for: Medical, Dental, Vision, Term Life Insurance, Accidental Death & Dismemberment Insurance, Short-Term Disability, and Employee Assistance Program. For more information, _. Target salary range: $83,720 - $96,280. The estimate displayed represents the typical salary range for this position based on experience and other factors.

Summit Consulting is seeking a Special Claims Investigator to detect and prevent fraudulent claims for Great American Insurance Group's SIU. The ideal candidate holds a Bachelor’s Degree in a relevant field and has 3 to 6 years of experience in Criminal Investigation or Fraud Detection.

SIU Investigator Job Description: We are seeking a meticulous and experienced SIU Investigator to join our team. SIU Investigator/h2pAbout Us: Insight Service Group (ISG) is a national investigative services firm specializing in cost containment and anti-fraud related services. Key Responsibilities

Affirmative Civil Enforcement (ACE) Investigator Employment Type: Full-Time, Experienced Department: Legal Services Location: New York, NY Albany, NY Salary: $51,435.CGS is seeking an experienced ACE Investigator with extensive knowledge and skills in investigative techniques and fraud detection to

Job Description ABOUT US: 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 actionable insights that translate into better decision-making for our clients. To learn more, visit: https://ethosrisk.com/about-us/ JOB SUMMARY: Have you ever thought about becoming a Private Investigator? Are you ready to kick-start your career in a rapidly growing industry? Want to get paid to learn how to investigate fraud and conduct covert surveillance in the real world? Our Full-Time Entry-Level Field Investigator position will help launch your career by providing you with an industry leading FULLY PAID Investigator Training Program - no prior experience necessary! KEY RESPONSIBILITIES: • Case Preparation: Conduct preliminary investigations using social media and analyzing database research., • 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 files by submitting case reports and uploading video footage via personal laptop at the end of the day., • Communication: Work closely with field supervisor, receiving regular guidance and mentorship. QUALIFICATIONS: • Driver's License: Active driver's license that is not currently suspended or revoked., • Personal Vehicle: A well-maintained vehicle that is always reliable (preferably with tinted windows). Proof of auto insurance coverage is required., • Travel Expectations: While we aim to keep assignments within a reasonable drive of your residence, occasional further travel and overnight stays (covered by the company) may be required., • Technology: A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks., • Required Skills: Strong computer & internet proficiency. Excellent communication, verbal & writing skills. WHAT WE OFFER: • Paid Investigator Training Program: Fully paid training program led by industry experts with ongoing development and support. Initial training will be held via virtual classroom then transition into on-the-job training., • Paid Licensing: We pay for all your licensing fees! Our licensing team will guide you through the process of acquiring all investigator licensing to ensure a smooth process., • Surveillance Equipment: We will provide you with necessary surveillance equipment. After a year of employment, it is yours to keep!, • Pay Increases & Milage Reimbursement: There are several performance milestones within your training & first year of employment that will reward you with pay increases. Additionally, we offer a mileage reimbursement program., • Health Insurance/Retirement: Medical, Dental Vision, Life/Disability Insurance + 401k WORKING CONDITIONS: • 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. Job Posted by ApplicantPro

Job DescriptionHealthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support 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.Preferred qualifications:- Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3.- Relevant experience working with a federal or state legal or law enforcement entity. #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Description 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 a Special Unit Investigations (SIU) Field Investigator to conduct field investigations, gather and analyze evidence, and produce detailed reports that support claims decisions. You'll work both independently and collaboratively, often traveling to accident scenes, interviewing witnesses, and uploading documentation into our claims system. KEY RESPONSIBILITIES: • Scene Investigations: Conduct thorough on-site investigations of accidents and property losses., • Interviews & Statements: Conduct in-person interviews and obtain accurate, detailed statements from all parties involved., • Online Research: Gather case information through digital sources and background checks., • Report Writing: Draft thorough, detailed investigative reports summarizing findings and observations., • Case Documentation: Conduct in-person interviews and obtain accurate, detailed statements from all parties involved, and retrieve relevant documents to support investigative findings., • Case Management: Track case progress, time, and expenses accurately within Ethos systems., • Fraud Detection: Recognize compensability issues, misrepresentation, and other red flags in claims., • Client Communication: Maintain professional contact with clients and claim handlers throughout the investigation process. QUALIFICATIONS: Education: Associate's or Bachelor's degree in Criminal Justice or a related field preferred. Experience: • Minimum of 2 years of SIU experience with an investigative firm or insurance carrier, working across various lines of business such as liability, auto, and property., • Former military or law enforcement background preferred. Licenses/Certifications: • Active Private Investigator license or willingness to obtain one (where required by state)., • Active driver's license and valid auto insurance. Other Requirements: • A well-maintained and reliable vehicle for exclusive use., • SIU equipment, including a recorder and a high-quality digital camera., • A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks. 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., • Occasional weekend work may be required to align with case demands and or/client requests. 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. Job Posted by ApplicantPro

ISG is currently seeking experienced and motivated individuals for Surveillance Investigator positions. Key Responsibilities as a Surveillance Investigator:/pulliConduct thorough investigations related to suspected fraud and misconduct. Surveillance Investigators must have the following qualificatio

This role focuses on preventing and investigating insurance claims fraud, requiring a Bachelor's degree in Criminal Justice or a related field. The ideal candidate will have 3-6 years of relevant experience in criminal investigation or fraud detection, with the ability to travel overnight as needed.

Job DescriptionDescription: Becker & Company is seeking skilled and experienced Field Investigators to join our team on a Full-Time basis. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability and aimed at mitigating expenses for our clients and delivering high-quality results. We are seeking a detail-oriented and proactive investigator to join our team. The ideal candidate will conduct a variety of investigations, including Surveillance and Special Investigations Unit (SIU) assignments, within an assigned geographical area. Surveillance assignments require the investigator to obtain videotape documentation of the subject and for SIU assignments the investigator must complete the assignment as per the instructions given by the case manager. Key Responsibilities: • Adhere to specific requirements of an assignment based upon the case manager's instructions, • Review all case materials prior to conducting investigative activity, • Complete video surveillance on identified individuals for the allotted amount of time and utilizes established investigative techniques to secure covert video footage, • Conduct investigations such as securing recorded statements, scene inspections, activity checks and securing documents as assigned, • Complete written notes on each case assignment in a timely manner, • Submit all videotaped results, photographs, and digital recordings via e-mail by the next business day, • Meet established deadlines set by the client, • Communicate effectively with the assigning case manager with regularity regarding the progress of assignments, • Ensure confidentiality of all information obtainedRequirements:, • Possess a valid state issued driver's license, • Possess a current private investigator license (if applicable), • Must be dependable and able to meet deadlines, • Must be a self-starter capable of working with limited supervision, • Possess investigative tools (Laptop, Video Cameras, Digital Recorder, etc.), • Possess strong writing and verbal communication skills, • Experience conducting surveillance as a field investigator, • Experience completing SIU claim investigations, • Possess a reliable vehicle

Job Description Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. Pay Transparency: The base pay for this role in the states of New Jersey and New York is: $65,412 - $85,853 per year. The base pay for this role is: $58,870 - $77,267 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities • Develop a depth of expertise on CPT, HCPCS, and ICD-10 Coding guidelines and other insurance billing submission requirements., • Perform complex audits of assigned medical records and claims on both a prepayment and post payment basis to determine accuracy of claims submitted to Oscar., • Document findings including reference to sources used to support decision making and in a way that can be easily understood by non clinicians or coders., • Create audit report findings, tools, and reference guide that can be used by other team members to communicate findings or more effectively perform similar reviews., • Help draft written communications to providers to convey audit findings., • Participate in educational calls with providers., • Help train new team members., • Develop and document processes to improve the effectiveness of the team., • Compliance with all applicable laws and regulations, • Other duties as assignedQualifications, • 2+ years of coding or auditing experience across multiple specialties is required, • Bachelor's degree or 4+ years of work experience, • Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC) designation or similar certification, • Experience working in production-based environment, • Experience of both outpatient and inpatient auditingBonus Points, • Certified Professional Medical Auditor (CPMA), • Additional certification applicable to this work such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), other coding certifications or similar, • Knowledge of applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity, • Demonstrated experience translating technical jargon to non-technical end users., • Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting., • Experience with HIPAA, data privacy, and/or data security processes, • Experience working with regulators governing (public or private) health insurance carriers This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

A governmental support organization is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN.

Job Description Position Summary: CFSB is a full-service payments, lending and banking provider that delivers global financial services through a personal approach. CFSB is seeking a highly skilled and detail-oriented Investigator to join our Financial Intelligence Unit (FIU) within the Compliance department. CFSB offers a full range of banking services including ACH settlement services, pre-paid card issuance, and retail banking. In addition to serving our general customer base, we also service various types of money service businesses and FinTech companies. This individual will be primarily responsible for conducting the investigative process, ensuring timely and accurate case reviews, and adherence to regulatory requirements. They will adhere to performance and quality expectations, while maintaining high standards for FIU investigations. This role is fully remote in 22 select states or hybrid for those located in the NYC Metro Area. Key Responsibilities: • Conduct investigation escalations, ensuring investigations are thorough, timely, and comply with regulatory requirements., • Proactively manage case management inventory to ensure all SLAs are adhered to., • Prepare reports related to escalations, ensuring the accuracy and clarity of case summaries, investigation findings, and recommended actions., • Support the development and enhancement of procedures and guidelines related to investigation escalations and reporting workflows., • Identify trends in escalated cases, working with leadership to develop strategies for addressing systemic issues or control gaps., • Collaborate and proactively propose any and all efficiency ideas with open and transparent communication., • Stay updated on regulatory changes and AML/BSA typologies, ensuring processes remain aligned with evolving compliance requirements., • Participate in special projects and initiative to enhance investigation escalation processes, strengthen related controls, and address other FIU priorities as needed., • Ability to adapt to evolving priorities in a dynamic regulatory and operational environment. Knowledge, Skills, and Abilities: • Strong knowledge of AML/BSA detection, investigation, and reporting processes, including SAR filing requirements., • The ability to assess complex investigation cases, identify potential risks, and recommend effective solutions., • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) or related software., • Strong analytical, organizational, and problem-solving skills., • Excellent verbal and written communication skills., • Ability to work both independently and collaboratively in a team environment. Education, Training, and Experience: • Bachelor’s degree in Business, Finance, Risk Management, Compliance, or related field; or equivalent work experience., • Minimum of 5 years of experience in Compliance, Audit, or Internal Controls., • Strong Financial Crimes and AML/BSA regulatory knowledge., • Understanding of Bank Operations, Payments Services, and overall financial services ecosystem. Experience with correspondent banking is strongly preferred; former experience working with fintech partnerships helpful., • Professional certification (e.g., CAMS, CFE) is a plus. Experience with financial services industry risks, fraud typologies, and regulations, including familiarity with fintech partnerships and payment systems. About Community Federal Savings Bank (CFSB) Community Federal Savings Bank (CFSB) is a federally chartered bank founded in 2001 and headquartered in New York City. CFSB has focused on providing superior service and added value to clients though a solid understanding of relationship banking. We offer a full range of services, including loans, bill payments, card services, internet banking, and merchant processing. We are an equal opportunity employer and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, military and/or veteran status, or any other Federal or State legally-protected classes.

Job Description Surveillance Investigator – Advantage Investigations WE'RE GROWING AND ADDING TO OUR TEAM OF FULL-TIME INVESTIGATORS! • FULL RATE Door to Door hourly pay, • Fuel Card provided, • Monthly Vehicle Allowance, • Monthly Cell Phone Allowance, • Equipment Provided Advantage Investigations has been the Nation’s only insurance defense investigation firm for the past 28 years. We invest in the operational capabilities necessary to produce consistent, high-quality results — ultimately helping our clients “See What’s True.” With over 200+ licensed private investigators nationwide, Advantage Investigations uses strategic planning and cutting-edge technology to deliver greater clarity on claimants’ daily activities. We specialize in covert surveillance, claims investigations, NetSweep investigations, remote-controlled surveillance, and more — saving our clients time and money on insurance fraud cases. Advantage Investigations is seeking a Full-time Surveillance Investigator / Private Investigator in Newark, NJ and the surrounding areas. The qualified candidate will be responsible for conducting daily covert surveillance, investigating daily activities, obtaining video evidence, and providing clear reports of all activities for our operations team, along with basic claims investigations. As a private investigator with Advantage Investigations, you will be provided with a comprehensive training program, door-to-door pay, fuel card, vehicle and phone allowance, top-of-the-line equipment, as well as other generous benefits. This position requires daily travel within the investigator’s area/territory. Duties & Responsibilities: • Conducting surveillance including covert, stationary, and mobile, • Conducting surveillance throughout their home state and surrounding states, • Recording subject activity on a video recording device, • Conducting alive and well checks, locates, basic scene investigations, paint sample analysis, EDR, and RCS deployments/retrievals, • Preparing and completing a written report of observations, • Uploading Video Evidence and a surveillance report Qualifications & Requirements: • Current NJ Private Investigator License preferred, • Private Investigator Licenses required – Licensing differs between states, • Previous experience related to surveillance/claims investigations is preferred, • Access to a reliable, suitable surveillance vehicle for day-to-day use, • Valid Driver’s License, • Ability to provide MVR (driving record), • Willingness to travel throughout home state and surrounding states for work, • Varying weekly work schedule includes weekend and holiday availability, • Good oral and written communication skills, • Self-motivated, ability to work independently, • Meet state mandated requirements to obtain and maintain a Private Investigator license in multiple states, • Must pass a Drug Screen Compensation: Investigators are paid door to door at an hourly rate commensurate with experience, within $20.00 to $24.00 an hour. Employees are paid on a bi-weekly basis. Company Benefits: • Door to Door hourly pay, • Fuel Card provided, • Monthly Vehicle Allowance, • Monthly Cell Phone Allowance, • Equipment Provided, • Medical, Dental, Vision, and Disability insurance, • Life Insurance and other supplemental options, • Paid Lodging (when applicable), and per diem pay when out of town, • 2 weeks of PTO (paid time off), • Parental Leave Advantage Investigations is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

SIU Investigator/h2pInsight Service Group (ISG) is a national investigative services firm specializing in cost containment and anti-fraud related services. Our Special Investigations Unit (SIU) plays a vital role in identifying and mitigating risks associated with fraud and misconduct. We are seekin

Senior Program Integrity Specialist. IDNYC is recruiting for three (3) Fraud Investigator II to function as Senior Program Integrity Specialist who will:.

CGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. Analyze data for evidence of fraud, waste, and abuse. Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.

Senior Program Integrity Specialist. IDNYC is recruiting for three (3) Fraud Investigator II to function as Senior Program Integrity Specialist who will:.

FSA Federal is focused on delivering unsurpassed services in support of law enforcement and homeland security. In this role, you will be supporting the overall mission of the United States Attorney's Office (USAO), Health Care & Government Fraud Unit (HCGFU). At FSA Federal, we recognize the diverse

Must be able to obtain a favorably adjudicated Public Trust Clearance.

The role involves performing core enforcement reviews, conducting deep-dive fraud investigations, and analyzing fraud trends using data tools. The role involves performing core enforcement reviews, conducting deep-dive fraud investigations, and analyzing fraud trends using data tools. Etsy Marketpla

A leading company is seeking a Senior Financial Investigator to provide legal support to a federal agency, focusing on complex investigations into financial crimes such as fraud and money laundering. The role requires a mix of analytical skills and investigative techniques, along with a commitment t

Certified Professional Coder (CPC), Accredited Healthcare Fraud Investigator (AFHI), Certified Insurance Fraud Investigator (CIFI), and/or Certified Economic Crime Forensic Examiner (CECFE) preferred (but not required). Knowledge of claims processing, reimbursement procedures, and a solid understand

A governmental support organization is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN.

A leading AI firm is seeking a Private Investigator to work on projects evaluating AI for fraud detection and security operations. Candidates should have over 4 years of experience in loss prevention or a related field, along with strong communication skills and a valid investigator license where ne

Independence Pet Group is seeking a Carrier Operations Fraud Analyst to oversee fraud investigations and maintain compliance with state regulations.This remote role requires a Bachelor’s degree and experience in insurance operations or fraud investigations.Responsibilities include leading investig

JOB DESCRIPTION We’re looking for a Clinical Healthcare Fraud Investigator to support a high volume of claims for a leading healthcare client. REQUIRED SKILLS AND EXPERIENCE 3+ years of healthcare fraud investigations experience (full lifecycle) 4+ years of medical coding experience Strong experie

Job DescriptionAffirmative 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:https://cgsfederal.com/join-our-team/For more information about CGS please visit: https://www.cgsfederal.com or contact:Email: info@cgsfederal.com #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Description Registered Nurse - Nursing Home Surveyor/Complaint Investigator - New York, NY (#6045A) • Location: New York City, NY – Bronx, Kings, Richmond, Manhattan, and Queens, • Employment Type: Temporary-to-permanent, • Hourly Rate: $60 per hour About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Position Overview: We are seeking a dedicated and experienced Registered Nurse - Nursing Home Surveyor/Complaint Investigator to join our team in New York City, NY (Bronx, Kings, Richmond, Manhattan, and Queens). This role is a temporary-to-permanent position that involves conducting surveys, complaint investigations, and surveillance activities at nursing homes to ensure compliance with Federal and State regulations. Why Join Us? • Competitive Compensation: Earn $60/hr with mileage reimbursement., • Flexibility: Enjoy a flexible schedule and the opportunity to work a temporary-to-permanent position., • Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive environment., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes. Qualifications: • Education: Bachelor’s degree in Nursing., • Licensure: Must hold an active NYS Registered Nurse license., • Experience:, • Minimum of 2 years of experience in utilization review, claims adjudication, medical review, fraud investigation, surveillance, or monitoring activities; OR, • 3 years of clinical or administrative experience; OR, • A Bachelor’s degree in Nursing and 2 years of clinical or administrative experience., • At least 1 year of survey experience is required., • Technical Skills: Strong computer skills with the ability to learn new programs., • Soft Skills: Strong attention to detail, excellent interpersonal and communication skills, superior investigative and analytical abilities. Can work independently and as part of a team., • Additional Requirements:, • SMQT Certification is preferred but must be obtained within 12 months of employment., • Must have a valid driver’s license and the ability to travel to on-site facilities. Key Responsibilities: • Participate in surveys and complaint investigations, including allegations of abuse and neglect, at nursing homes (long-term care facilities)., • Produce written documentation and draft Statements of Deficiencies (SOD) within required timeframes using Principles of Documentation., • Assess compliance with Plans of Correction within required timeframes., • Complete data entry in federal and state reporting databases as required., • Participate in state monitoring during immediate jeopardy situations., • Attend meetings and testify in administrative hearings as needed., • Adhere to DOH work schedules, policies, and procedures., • Travel to onsite locations according to the work schedule. Greenlife Healthcare Staffing – Empowering Healthcare Professionals, Enriching Lives.

A leading health organization seeks an investigator for healthcare fraud allegations. Preferred candidates will have a minimum of 5 years in fraud investigations.

Framework Ventures is looking for a Senior Financial Crimes Investigator in the United States. You will focus on Bank Secrecy Act compliance, fraud prevention, and investigations across various financial products. The role involves collaboration with multiple teams to mitigate fraud risks and mainta

Would you like to be part of a team that keeps the cast, crew, celebrity guests and co-workers at The Walt Disney Company safe and secure? Our Security Officers do it all, from working special events like Disney shows to regular perimeter checks of our buildings and offices.If you thrive in an envir

The Administrative Assistant to Director provides daily administrative and operational support to help the Director stay informed, organized, and prepared.This role owns reporting follow-up, meeting coordination, department communication, and task tracking while working closely with managers across

The Center for Human Reproduction (CHR) is a leading fertility center based in New York City, recognized nationally and internationally for treating patients with multiple failed IVF cycles.Founded as one of the first IVF centers in the U.CHR specializes in treatment for diminished ovarian reserve.O

We're currently looking for individuals across the country to take part in remote paid research, including remote focus groups, product trials, and consumer studies.Earn up to $750 a week in your free time by providing feedback on everyday products and services.If you're comfortable sharing your opi