- Manulife Financial (Boston, MA)
- …identify temporal patterns and trends in fraudulent behavior Develop anomaly detection systems to flag unusual claims patterns, provider behaviors, and ... uncover fraud indicators Leverage large language models (LLMs) for analyzing unstructured claims data, policy documents, and investigator notes to identify fraud… more
- The Association of Technology, Management and Applied… (Poughkeepsie, NY)
- …and procedures of the Institute, and serves as a Title IX complaint investigator as needed. Issues independent findings based on a preponderance of the evidence ... changes relating to their areas of responsibility. Manages assigned legal claims , coordinating with outside counsel and relevant internal offices as appropriate.… more
- Allied Universal (Jacksonville, FL)
- …explore a career with us and make a difference. Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...This position will also review database information found in systems such as Unitrac, insurance company websites, Lexis Nexis,… more
- AIG (Atlanta, GA)
- …and reporting on findings. The investigator will provide assistance to the claims adjuster in progressing the claim and will leverage knowledge and expertise ... customers to manage risk. Join us as a Principal Claims Investigator to play your part in...financial impact for cases worked in the case management system . + Assist GIS and local management as appropriate… more
- NJ Transit (Newark, NJ)
- Investigator A ( Claims ) Finance Job Description: Move forward with us! At NJ TRANSIT, you'll join us in transforming the third-largest transportation agency in ... public agencies. + Carrying out negotiations in adjusting of claims and entering of settlements with attorneys. + Obtaining...maintaining a calendar of upcoming events; maintaining a diary system . + Maintaining both paper and electronic claim… more
- C&S Wholesale Grocers, Inc. (Lumberton, NC)
- …Description** **Description** + This position will report directly to the Claims Manager and conduct detailed investigations by recovering all documentation ... regarding Customer shortage requests ensuring that all pending claims are researched and processed within the agreed upon...operations are essential Knowledge of C&S warehouse and office system applications + Special Skills : + Physical abilities:… more
- Allied Universal (Palm Coast, FL)
- …difference. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- CareFirst (Baltimore, MD)
- …of audits of financial business records, provider and subscriber medical data, claims , systems report, medical records, analysis of contract documents, ... for offsite audits/investigations and interviews when requested. Research provider/subscriber claims activity, operations manuals, data systems , medical… more
- Kemper (Doral, FL)
- …to our stakeholders that delivers on our promises._ **Position Summary:** The SIU Investigator will conduct field as well as desk investigations of insurance ... claims referred to and accepted for investigation by the Special Investigative Unit. Our Special Investigator will function as a remote investigator working… more
