871 Investigator jobs in the United States

$57,000 - $62,000 per year
At CoreCivic, our employees
are driven by a deep sense of service, high standards of professionalism and a
responsibility to better the public good. We are currently seeking an **Investigator** who has a passion for providing the highest quality care in an
institutional, secure setting. Come join a team that is dedicated to
making an impact for the people and communities we serve.
The Investigator is responsible for the supervision of all internal investigations within the facility as assigned by facility management, Facility Support Center management, or Legal Department.
+ Conduct internal investigations of allegations of misconduct by staff, to include but no limited to contractors, consultants, and volunteers.
+ Investigate grievances, facility incidents, policy violations and all felonies committed by inmates and/or staff.
+ Serve as a liaison to contract partner and law enforcement agencies, and shares information, investigative findings and intelligence as required.
+ Collect and/or supervise the collection and preservation of evidence on a consistent level to preclude tampering and contamination.
+ Secure and maintain all evidence in accordance with policy and procedure, and local rules of evidence.
+ Respond to subpoenas and provides legal testimony in court proceedings or administrative hearings, when necessary.
2024 CoreCivic Benefits Overview ( CoreCivic Benefits Overview (Safety non-SCA facilities) FINAL.pdf)
**Qualifications:**
+ Graduate from an accredited college or university with a Bachelor's degree is required.
+ Two years of experience conducting investigations is required.
+ Additional experience in corrections, law enforcement, probation and parole or investigations may be substituted for the required education on a year-for-year basis.
+ Experience in Microsoft Office or other similar software applications is required.
+ A valid driver's license is required.
+ Minimum age requirement: Must be at least 18 years of age.
_CoreCivic is a Drug-Free Workplace and EOE-including Disability/Veteran._

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job is responsible for developing and maintaining an anti-fraud program which includes development and delivery of training and filing of Fraud Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged fraud, waste and abuse perpetrated by providers, members, facilities, pharmacies, groups and/or employees of the organizations and Subsidiaries. The incumbent is responsible for interviews which might include providers and members and may be conducted onsite or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to fraud, waste and abuse. The incumbent must be able to testify in a court of law, prepare cases for referral to various federal, state and local law enforcement entities and work with those agencies through closure of the case. Conduct audits for proactive and investigative purposes to comply with internal audit and regulatory requirements.
**ESSENTIAL RESPONSIBILITIES**
+ Performs investigations into potential and existing provider and member fraud, waste and abuse activities.Identifies parties involved by reviewing inquiries and complaints against providers, members, facilities, pharmacies, groups, and/or employees of Highmark and Subsidiaries.Conduct Interviews with providers, members or any other individual(s) necessary to complete an assigned investigation or special project.Determines the scope of the allegation or special project by assembling the necessary information, statistics, policies and procedures, licensure information, doctors' agreements, contract, etc.
+ Develop and maintain annual anti-fraud program which includes facilitating fraud training and fraud awareness day, as well as filing annual fraud plans and reports according to state regulations. Responsible for updating annually the changes in insurance laws with regard to lines of business
+ Coordinates data extracts by assessing multiple databases both internally and externally.Takes action to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies.
+ Responsible for completing all necessary field (externally) investigative work for resolution or alleged fraud/waste and abuse cases or special projects.
+ Provides advisory support as needed to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee.
+ Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated funds paid by Highmark and affiliated companies and work with Finance to ensure proper recording the financial statements.
+ Conduct audits for proactive and investigative purposes to comply with internal audit and regulatory requirements. Audits consist of contract, commissions, surveillance, workers' compensation and IME. In addition, this position will complete Office of Foreign Asset Control (OFAC) to ensure payments are not issued to unauthorized parties.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Bachelor's Degree in Accounting, Finance, Business Administration, Nursing, IT or Related Field
**Substitutions**
+ 6 years of related and progressive experience in lieu of Bachelor's degree
**Preferred**
+ Master's Degree in Fraud, Forensics Accounting, Business or related field
**EXPERIENCE**
**Required**
+ 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations
**Preferred**
+ 1 year in Financial Analysis in an acute care hospital or health insurance setting
+ 1 year in professional billing, facility Patient Financial Services, HIM, Internal Audit, Professional/Facility Reimbursement or Provider Contracting
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred** (any of the following)
+ Certified Fraud Examiner (CFE)
+ Certified Professional Coder (CPC)
+ Certified Outpatient Coder (COC)
+ Accredited Healthcare Fraud Investigator (AHFI)
**SKILLS**
+ Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency
+ Must have understanding of technical and financial aspects of the health insurance industry
+ Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required
+ Must possess excellent communication skills and be detailed oriented
+ Strong written and oral communication skills
+ Strong relationship building skills
+ Client focused with strong business acumen
+ Self-starter with the ability to work under pressure independently and as part of a team
+ Ability to think strategically and act proactively to create strong trust and confidence with business units
+ Strong innovative problem-solving capabilities
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$57,700.00
**Pay Range Maximum:**
$107,800.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J265531

Job Description
Insight Global is looking for Sr. AML Investigators to work on site for one of our customers supporting their current GFC Complex Investigations team. This person will assume the role of Sr. Investigator and is responsible for maintaining certain aspects of the AML/GFC program and assists in meeting and maintaining BSA/AML compliance requirements of the client. Complies with all applicable, federal and state laws, regulations and guidance, including those related to Anti-Money Laundering (i.e. Bank Secrecy Act, USA PATRIOT Act, etc.), as well as adhering to the Bank's policies and procedures to mitigate risk exposure to the Bank.
We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form ( . The EEOC "Know Your Rights" Poster is available here ( .
To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: .
Skills and Requirements
5-7+ years AML Investigations background
* Worked in a large enterprise financial environment
* Experience with Quality Control Reviews over reports or Lead Analyst experience
* In depth experience with Complex Investigations across various domains
* In depth experience filing SAR's and Supplemental SAR filings as it relates to Investigations
* Strong communication skills with the ability to interact with external customer and internal staff including the Frontline, Middle management and Senior management.
* Knowledge of applicable laws, regulations, and guidelines for BSA compliance
* Proven ability to work without significant supervision and completing tasks by assigned deadlines.
* Strong written communication and analytical thinking with the ability to solve complex problems
* Ability to manage multiple concurrent projects and assignments
* Ability to utilize technology in solving problems and performing duties.
* Lead daily investigation workflow, controls and results metrics for the team
* Set clear goals/objectives and motivate teams to achieve superior results
* Assess internal trends, external regulatory & law enforcement environment to make recommendations, understand risk areas and alter or add to current processes
* Oversee complex financial investigations, sanctions reviews, or other AML Processes
* Manage a team of analysts who will perform a centralized review function to capture, document and assess an individual customer's Bank Secrecy Act (BSA)/AML risks.
* Work in conjunction with other functional areas of the Bank to ensure the enterprise level BSA-AML objectives are being met * CAMS, CAFP, or ACFCS, or other related certification
* AML Management or Supervisory experience
* Previous Law Enforcement or Agency Experience null
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to

**$60,000.00 -$65,000.00/yearly**
At CoreCivic, our employees
are driven by a deep sense of service, high standards of professionalism and a
responsibility to better the public good. We are currently seeking an **Investigator** who has a passion for providing the highest quality care in an
institutional, secure setting. Come join a team that is dedicated to
making an impact for the people and communities we serve.
The Investigator is responsible for the supervision of all internal investigations within the facility as assigned by facility management, Facility Support Center management, or Legal Department.
+ Conduct internal investigations of allegations of misconduct by staff, to include but no limited to contractors, consultants, and volunteers.
+ Investigate grievances, facility incidents, policy violations and all felonies committed by inmates and/or staff.
+ Serve as a liaison to contract partner and law enforcement agencies, and shares information, investigative findings and intelligence as required.
+ Collect and/or supervise the collection and preservation of evidence on a consistent level to preclude tampering and contamination.
+ Secure and maintain all evidence in accordance with policy and procedure, and local rules of evidence.
+ Respond to subpoenas and provides legal testimony in court proceedings or administrative hearings, when necessary.
**Qualifications:**
+ Graduate from an accredited college or university with a Bachelor's degree is required.
+ Two years of experience conducting investigations is required.
+ Additional experience in corrections, law enforcement, probation and parole or investigations may be substituted for the required education on a year-for-year basis.
+ Experience in Microsoft Office or other similar software applications is required.
+ A valid driver's license is required.
+ Minimum age requirement: Must be at least 18 years of age.
_CoreCivic is a Drug-Free Workplace and EOE-including Disability/Veteran._

**$53,000.00 - $57,000.00 per year**
At CoreCivic, our employees
are driven by a deep sense of service, high standards of professionalism and a
responsibility to better the public good. We are currently seeking an **Investigator** who has a passion for providing the highest quality care in an
institutional, secure setting. Come join a team that is dedicated to
making an impact for the people and communities we serve.
The Investigator is responsible for the supervision of all internal investigations within the facility as assigned by facility management, Facility Support Center management, or Legal Department.
+ Conduct internal investigations of allegations of misconduct by staff, to include but no limited to contractors, consultants, and volunteers.
+ Investigate grievances, facility incidents, policy violations and all felonies committed by inmates and/or staff.
+ Serve as a liaison to contract partner and law enforcement agencies, and shares information, investigative findings and intelligence as required.
+ Collect and/or supervise the collection and preservation of evidence on a consistent level to preclude tampering and contamination.
+ Secure and maintain all evidence in accordance with policy and procedure, and local rules of evidence.
+ Respond to subpoenas and provides legal testimony in court proceedings or administrative hearings, when necessary.
**Qualifications:**
+ Graduate from an accredited college or university with a Bachelor's degree is required.
+ Two years of experience conducting investigations is required.
+ Additional experience in corrections, law enforcement, probation and parole or investigations may be substituted for the required education on a year-for-year basis.
+ Experience in Microsoft Office or other similar software applications is required.
+ A valid driver's license is required.
+ Minimum age requirement: Must be at least 18 years of age.
_CoreCivic is a Drug-Free Workplace and EOE-including Disability/Veteran._

Job Description

Job Description

Ethos Risk Services is continuing to expand our team of Private Field Surveillance Investigators !

We are looking for Experienced Licensed Investigators in the Kansas City area to investigate fraud and conduct covert surveillance in the field (from your vehicle).

Ethos Risk is one of the largest and most respected fraud investigations businesses in the US. Join us in uncovering the facts, keeping insurance costs from rising, and serving our clients in a fully remote position.

Are you ready to join the best fraud investigation company in the industry? Apply now!

Ethos Risk Services: What drives us

At Ethos, you'll find more than just a job - you'll discover a purposeful career where your contributions make a lasting impact. Join us and become a trusted partner in insurance claims management and fraud investigations, delivering certainty and peace of mind to every client we serve.

What does aN Experienced FIELD Surveillance Investigator do?

As a Surveillance Investigator at Ethos Risk Services, you will conduct covert surveillance, review files, and draft detailed case reports. Working autonomously from your vehicle, you will capture video evidence of surveillance targets, collaborate with our Operations Managers, and ultimately improve the integrity of the health care and insurance industry. Join a team that celebrates high performers, values employees, and delivers results.

What you need to be successful

To qualify for this position candidates must possess:

• A valid private investigator license
• A valid driver's license
• A well-maintained / reliable vehicle (preferably with tinted windows)

In this role you will use discretion, communicate with our Operations Managers regularly, and apply critical thinking skills while conducting surveillance and gathering evidence. Adaptability, attention to detail, and strong analytical capabilities are essential qualities for success at Ethos.

Candidates who are self-motivated, resourceful, and able to maintain a high level of professionalism in various situations will thrive in this position.

Work Schedule

Most investigations will begin at 6AM and may require you to leave your home between 4-5AM. Candidates who are willing to work most weekends and holidays will be prioritized in the hiring process.

Make your move

If you think this position is a fit for what you are looking for, applying is a snap - just follow the instructions on this page. Good luck!

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 protected by law.

A background check will be conducted, in accordance to the local state law and regulations.

Job Posted by ApplicantPro

Job Description

Job Description

Ethos Risk Services is continuing to expand our team of Private Field Surveillance Investigators !

We are looking for Experienced Licensed Investigators in the Kansas City area to investigate fraud and conduct covert surveillance in the field (from your vehicle).

Ethos Risk is one of the largest and most respected fraud investigations businesses in the US. Join us in uncovering the facts, keeping insurance costs from rising, and serving our clients in a fully remote position.

Are you ready to join the best fraud investigation company in the industry? Apply now!

Ethos Risk Services: What drives us

At Ethos, you'll find more than just a job - you'll discover a purposeful career where your contributions make a lasting impact. Join us and become a trusted partner in insurance claims management and fraud investigations, delivering certainty and peace of mind to every client we serve.

What does aN Experienced FIELD Surveillance Investigator do?

As a Surveillance Investigator at Ethos Risk Services, you will conduct covert surveillance, review files, and draft detailed case reports. Working autonomously from your vehicle, you will capture video evidence of surveillance targets, collaborate with our Operations Managers, and ultimately improve the integrity of the health care and insurance industry. Join a team that celebrates high performers, values employees, and delivers results.

What you need to be successful

To qualify for this position candidates must possess:

• A valid private investigator license
• A valid driver's license
• A well-maintained / reliable vehicle (preferably with tinted windows)

In this role you will use discretion, communicate with our Operations Managers regularly, and apply critical thinking skills while conducting surveillance and gathering evidence. Adaptability, attention to detail, and strong analytical capabilities are essential qualities for success at Ethos.

Candidates who are self-motivated, resourceful, and able to maintain a high level of professionalism in various situations will thrive in this position.

Work Schedule

Most investigations will begin at 6AM and may require you to leave your home between 4-5AM. Candidates who are willing to work most weekends and holidays will be prioritized in the hiring process.

Make your move

If you think this position is a fit for what you are looking for, applying is a snap - just follow the instructions on this page. Good luck!

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 protected by law.

A background check will be conducted, in accordance to the local state law and regulations.

Job Posted by ApplicantPro

Join Our Team as a Threat Investigator!

About 10a Labs:

At 10a Labs, our Investigations Team is on the front lines, tackling critical safety incidents and conducting thorough investigations across various abuse areas. From Violence and Hate to Mental Health and Child Safety, we are dedicated to making a difference.

About the Role:

As a Threat Investigator , you'll play a vital role in supporting our Investigations Team. Your mission? To detect and respond to malicious activities, investigate incidents, draft insightful reports, and provide actionable recommendations. This role requires a keen understanding of threat actors and harmful behaviors, along with strong skills in SQL and Python for data analysis.

Be prepared to engage with sensitive and distressing content, including sexual and violent material. Your work will be impactful, and your findings will help shape our safety protocols.

On-Call Responsibilities: This position includes an on-call component, requiring you to resolve urgent escalations outside of regular hours, including evenings and weekends. Typically, you’ll be on-call for 7 consecutive days each month, but flexibility is key as operational needs may shift.

Your Key Responsibilities:

• Proactively identify and address bad actors on our platform.
• Investigate potentially policy-violating activities by querying internal data sources using SQL and Python, while cross-referencing open-source information.
• Document and share your investigative findings with internal stakeholders to drive improvements.

What We’re Looking For:

• Must be U.S.-based and able to work West Coast hours (9am - 5pm PT).
• Willingness to be on-call for urgent escalations outside of normal work hours.
• Familiarity with technical investigations and detection pipelines, especially using SQL and Python.
• At least 3+ years of experience in related fields.
• Ability to quickly switch contexts across various domains and abuse areas.
• A passion for working in a fast-paced, ambiguous environment with a meaningful impact.

Desired Qualities (Not Required):

• Full professional proficiency in Arabic, Chinese, Farsi, Portuguese, Russian, or Spanish.
• Experience in scaling and automating processes, particularly with language models.
• Familiarity with AI safety, child safety, digital mental health, spam and fraud abuse, and related topics.

At 10a Labs, we believe that diversity is essential to our mission. We welcome applications from candidates of all backgrounds and are committed to fostering an inclusive and equitable work environment. Join us in making a difference!

Join Our Team as a Threat Investigator!

About 10a Labs:

At 10a Labs, our Investigations Team is on the front lines, tackling critical safety incidents and conducting thorough investigations across various abuse areas. From Violence and Hate to Mental Health and Child Safety, we are dedicated to making a difference.

About the Role:

As a Threat Investigator , you'll play a vital role in supporting our Investigations Team. Your mission? To detect and respond to malicious activities, investigate incidents, draft insightful reports, and provide actionable recommendations. This role requires a keen understanding of threat actors and harmful behaviors, along with strong skills in SQL and Python for data analysis.

Be prepared to engage with sensitive and distressing content, including sexual and violent material. Your work will be impactful, and your findings will help shape our safety protocols.

On-Call Responsibilities: This position includes an on-call component, requiring you to resolve urgent escalations outside of regular hours, including evenings and weekends. Typically, you’ll be on-call for 7 consecutive days each month, but flexibility is key as operational needs may shift.

Your Key Responsibilities:

• Proactively identify and address bad actors on our platform.
• Investigate potentially policy-violating activities by querying internal data sources using SQL and Python, while cross-referencing open-source information.
• Document and share your investigative findings with internal stakeholders to drive improvements.

What We’re Looking For:

• Must be U.S.-based and able to work West Coast hours (9am - 5pm PT).
• Willingness to be on-call for urgent escalations outside of normal work hours.
• Familiarity with technical investigations and detection pipelines, especially using SQL and Python.
• At least 3+ years of experience in related fields.
• Ability to quickly switch contexts across various domains and abuse areas.
• A passion for working in a fast-paced, ambiguous environment with a meaningful impact.

Desired Qualities (Not Required):

• Full professional proficiency in Arabic, Chinese, Farsi, Portuguese, Russian, or Spanish.
• Experience in scaling and automating processes, particularly with language models.
• Familiarity with AI safety, child safety, digital mental health, spam and fraud abuse, and related topics.

At 10a Labs, we believe that diversity is essential to our mission. We welcome applications from candidates of all backgrounds and are committed to fostering an inclusive and equitable work environment. Join us in making a difference!