Top 39 Insurance fraud investigator Jobs in Virginia

Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Virginia
- $46,988 - $112,200 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Senior Investigator (Full-time, Remote)
Integrity Management Services, Inc. —Alexandria, VA
- $55,000 - $85,000 a year
- Full-time
- Remote
- Microsoft Excel
- Organizational skills
- Senior level
- Paid holidays
- Disability insurance
Quick Apply
1d
Senior Investigative Analyst (Fraud Analytics & Investigative Support)
Praescient Analytics —Fairfax, VA
- Online Application
- Remote
- 3 years
- SQL
- Analysis skills
- Paid holidays
- Tuition reimbursement
Quick Apply
14d
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Richmond, VA
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
23h
Senior Financial Investigator
Contact Government Services, LLC —Fairfax, VA
- $74,156.16 - $107,114.45 a year
- Full-time
- Hybrid work
- Mid-level
- Driver's License
- Presentation skills
- Health insurance
- Dental insurance
Quick Apply
Senior Compliance Investigator
Centene —Virginia
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Affirmative Civil Enforcement (ACE) Investigator
Contact Government Services, LLC —Fairfax, VA
- $51,435.30 - $66,131.10 a year
- Full-time
- Hybrid work
- Microsoft Access
- Microsoft Outlook
- Office
- Health insurance
- Dental insurance
Quick Apply
Investigator - Northern Virginia
SpyCloud —McLean, VA
- $120,000 - $180,000 a year
- Full-time
- Computer Science
- 5 years
- Analysis skills
- Health savings account
- Paid holidays
Quick Apply
Virginia, Newport News SIU Investigator PT
Insight Service Group (ISG) —Newport News, VA
- $20 - $27 an hour
- Part-time
- Mid-level
- Driver's License
- Travel
Quick Apply
Sanctions Risk Specialist, GBS - Denied Party Screening
Amazon.com Services LLC —Virginia
- $55,600 - $97,400 a year
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- AD&D insurance
- Health insurance
Virginia, Fredericksburg SIU Investigator PT
Insight Service Group (ISG) —Fredericksburg, VA
- $20 - $27 an hour
- Part-time
- Mid-level
- Driver's License
- Travel
Quick Apply
Senior Forensic Accountant (Fraud Analytics & Investigative Support)
Praescient Analytics —Fairfax, VA
- Online Application
- Remote
- CPA
- 5 years
- Analysis skills
Quick Apply
14d
Business Analyst (Fraud Analytics & Investigative Support)
Praescient Analytics —Fairfax, VA
- Online Application
- Remote
- Mid-level
- 3 years
- SQL
- Paid holidays
- Tuition reimbursement
Quick Apply
14d
Surveillance Investigator
Frasco Inc —Alexandria, VA
- $20 - $26 an hour
- Weekends as needed
- Clean driving record
- Military
- High school diploma or GED
- Paid training
- Mileage reimbursement
Licensed Covert Surveillance Investigator - Part Time - Fairfax, VA
Meridian Investigative Group, Inc —Fairfax, VA
- $20 - $30 an hour
- Extended hours
- Microsoft Word
- Computer literacy
- Writing skills
Virginia, Chesapeake SIU Investigator PT
Insight Service Group (ISG) —Chesapeake, VA
- $20 - $27 an hour
- Part-time
- Mid-level
- Driver's License
- Travel
Quick Apply
Virginia, Lynchburg SIU Investigator PT
Insight Service Group (ISG) —Lynchburg, VA
- $20 - $27 an hour
- Part-time
- Mid-level
- Driver's License
- Travel
Quick Apply
Data Scientist (Fraud Analytics & Investigative Support)
Praescient Analytics —Fairfax, VA
- Online Application
- Remote
- Mid-level
- 3 years
- SQL
- Paid holidays
- Tuition reimbursement
Quick Apply
14d
SIU / Claims Investigator - Central / South VA
Allied Universal® Compliance and Investigations —Norfolk, VA
- $25 - $32 an hour
- Weekends as needed
- Military
- Computer literacy
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
8d
Licensed Covert Surveillance Investigator - Part Time - Virginia Beach, VA
Meridian Investigative Group, Inc —Virginia Beach, VA
- $20 - $30 an hour
- Extended hours
- Microsoft Word
- Computer literacy
- Writing skills

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insurance fraud investigator jobs near virginia

Senior Investigator, Special Investigations Unit (Aetna SIU)

CVS Health -
Virginia

Apply Now

Job Details

Full-time
$46,988 - $112,200 a year

Benefits

Health insurance
Dental insurance
Paid time off
Work from home
Vision insurance

Qualifications

Microsoft Word
Healthcare financial misconduct investigations
Customer communication
Microsoft Excel
Microsoft Outlook
Research
Insurance investigations

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

This position can be work from home anywhere in the United States.

Position Summary

We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), Self-Funded investigations team.

In this role, you will manage complex investigations into suspected and known acts of healthcare fraud, waste and abuse (FWA).

Key Responsibilities

Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.
Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers.
Research and prepare cases for clinical and legal review.
Document all appropriate case activity in case tracking system.
Prepare written case summaries and make referrals to State and Federal Agencies within the timeframes required by Law.
Facilitate the recovery of company and customer money lost as a result of fraud, waste and abuse.
Cooperate with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud.
Demonstrate high level of knowledge and expertise during interactions with internal and external partners.
Provide trial testimony in support of criminal or civil proceedings.
Give frequent presentations to internal and external customers regarding ongoing case investigations.
Respond quickly and accurately to questions and leads from internal and external customers.
Exercises independent judgment and uses available resources and technology to develop evidence in support of case investigations.

Required Qualifications

3-5 years investigative experience in the area of healthcare fraud, waste and abuse.
Experience in in Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research.
Ability to travel approximately 10% of time for business purposes.

Preferred Qualifications

Certified Professional Coder (CPC), AHFI, CFE
Knowledge of CVS/Aetna's policies and procedures
Understanding of self-funded insurance plan operations
Strong communication and customer service skills and the ability to effectively interact with Aetna's customers
Resident of North Carolina

Education

Bachelor's degree preferred or equivalent work experience.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $112,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 07/27/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

insurance fraud investigator jobs in virginia

Senior Investigator, Special Investigations Unit (Aetna SIU)

Senior Investigator (Full-time, Remote)

Senior Investigative Analyst (Fraud Analytics & Investigative Support)

Investigator, Special Investigations Unit (Meritain Health)

Senior Financial Investigator

Senior Compliance Investigator

Affirmative Civil Enforcement (ACE) Investigator

Investigator - Northern Virginia

Virginia, Newport News SIU Investigator PT

Sanctions Risk Specialist, GBS - Denied Party Screening

Virginia, Fredericksburg SIU Investigator PT

Senior Forensic Accountant (Fraud Analytics & Investigative Support)

Business Analyst (Fraud Analytics & Investigative Support)

Surveillance Investigator

Licensed Covert Surveillance Investigator - Part Time - Fairfax, VA

Virginia, Chesapeake SIU Investigator PT

Virginia, Lynchburg SIU Investigator PT

Data Scientist (Fraud Analytics & Investigative Support)

SIU / Claims Investigator - Central / South VA

Licensed Covert Surveillance Investigator - Part Time - Virginia Beach, VA

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