Top 319 Claims Jobs in Charleston Wv

Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Charleston, WV
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
Claims Analyst - REMOTE
Ryder System —Charleston, WV
- $90,000 - $100,000 a year
- Full-time
- Remote
- Bachelor's degree
- Experience equivalent to degree accepted
- Senior level
- Disability insurance
- Health insurance
Administrative Services Assistant 1
State of West Virginia —Kanawha County, WV
- $32,862 - $56,373 a year
- Full-time
- Office
- Administrative experience
- Bachelor's degree
Safety Officer
Triton Construction, Inc. —Saint Albans, WV
- From $32 an hour
- Full-time
- Construction site
- Mid-level
- In-person
- Health insurance
- Dental insurance
Quick Apply
Charleston, WV (Psychiatrist or Psychologist with Office (vA))
Sentinel Health Services —Charleston, WV
- $90 - $400 a day
- Multiple hires
- Private practice
- Psychiatry
- Physical & Rehabilitation Medicine
- Flexible schedule
Licensed Mental Health Therapist - Remote (LICSW, LPC)
Talkspace —West Virginia
- $70 an hour
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Continuing education credits
3d
Commercial Lines Account Manager
Blue Ridge Risk Partners —Charleston, WV
- $42,000 - $55,000 a year
- Full-time
- Writing skills
- Mid-level
- Office
- Disability insurance
- Health insurance
Quick Apply
CDL A Lease Purchase Truck Driver - OTR
MN89 INC —West Virginia
- $2,500 - $3,500 a week
- Heavy lifting
- CDL A
- Mid-level
- Fuel card
Quick Apply
Pharmacy Order Entry Technician, Midshift
Pharmacy Solutions Group of WV —Cabin Creek, WV
- Full-time
- Organizational skills
- Entry level
- Commercial
- Health insurance
- Dental insurance
Security Officer - Walking Patrol
Allied Universal —Charleston, WV
- $15.50 an hour
- Part-time
- 18 years or older
- CPR Certification
- Ability to walk for extended periods
- Paid training
- Opportunities for advancement
Quick Apply
1d
Casualty Claim Specialist I
AIG Claims, Inc. —Charleston, WV
- Email
- Microsoft Excel
- Microsoft Outlook
- Customer service
- Health insurance
Quick Apply
2d
Claims Investigator - Part Time
Command Investigations, LLC —Charleston, WV
- $23 - $30 an hour
- Overtime
- Microsoft Excel
- Microsoft Outlook
- Customer service
Quick Apply
Medical Records Coder 1 -- Coding & Data Registry -- Document Center Building
Mon Health —Charleston, WV
- Overtime
- Surgery
- No experience needed
- Mid-level
Senior Claims Representative - REMOTE
Ryder System —Charleston, WV
- $75,000 - $80,000 a year
- Remote
- Management
- 5 years
- Bachelor's degree
- Disability insurance
- Health insurance
Senior Claims Specialist - West Virginia
CorVel Corporation —Charleston, WV
- $59,681 - $96,123 a year
- Full-time
- Remote
- 6 years
- Customer service
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Registration Specialist- Internal Medicine Charleston
THOM Thomas Hospitals —South Charleston, WV
- Full-time
- Hospital
- Internal Medicine
- High school diploma or GED
14d
Medical Records Coder 1 -- Coding & Data Registry -- Document Center Building
CAMC Health System —Charleston, WV
- Overtime
- Surgery
- No experience needed
- Mid-level
(Hybrid) Health Data Analyst Senior - Health Affairs Institute
West Virginia University —Charleston, WV
- Full-time
- HIPAA
- 3 years
- Master's degree
- Paid holidays
- Health insurance
Registration Representative -- Cardiology South Charleston -- South Charleston- 4610 Kanawha Ave
Mon Health —South Charleston, WV
- Overtime
- Hospital
- Inventory management
- High school diploma or GED
Lead Director, Stop Loss Relationship Management
CVS Health —Charleston, WV
- $100,000 - $231,540 a year
- Full-time
- Bachelor's degree
- Fair chance
- Experience equivalent to degree accepted
- Health insurance
- Dental insurance

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claims jobs near charleston wv

Investigator, Special Investigations Unit (Meritain Health)

CVS Health -
Charleston, WV

Apply Now

Job Details

Full-time
$46,988 - $122,400 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Healthcare financial misconduct investigations
Claim investigation
Process audits
Spreadsheets
Research
Documentation tools
Insurance investigations
Productivity software
Healthcare ethical conduct investigations
Excel data analysis

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.

Job Description

As an independently owned subsidiary of Aetna and CVS Health, Meritain Health is a leading third-party administrator of self-insured commercial health plans. The SIU Investigator will support Meritain Health’s Network Cost Management team, specifically the Special Investigations Unit (SIU).

The SIU Investigator will conduct investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices.

The SIU Investigator:

Must be flexible to work EDT hours (8:00 am - 5 pm EDT).
Conducts investigations to effectively pursue the prevention, investigation, and prosecution of healthcare fraud and abuse, in order to recover lost funds, as well as to comply with state regulations mandating fraud plans and practices.
Conducts investigations of known or suspected acts of healthcare fraud and abuse.
Communicates with federal, state, and local law enforcement agencies as appropriate in matters pertaining to the prosecution of specific healthcare fraud cases.
Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc.
Facilitates the recovery of company and customer money lost as a result of fraud matters.
Provides input regarding controls for monitoring fraud related issues within the business units.
Delivers educational programs designed to promote deterrence and detection of fraud and minimize losses to the company
Maintains open communication with constituents internal and external to the company.
Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse.
Researches and prepares cases for clinical and legal review.
Documents all appropriate case activity in tracking system.
Makes referrals and deconflictions, both internal and external, in the required timeframe.
Cost effectively manages use of outside resources and vendors to perform activities necessary for investigations.

Required Qualifications

3+ years of experience working in fraud, waste and abuse investigations and audits.
3+ years of experience in healthcare/medical insurance claims investigation or professional/clinical experience.
Demonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information.

Preferred Qualifications

Strong analytical and research skills.
Strong verbal and written communication skills.
Strong customer service skills.
Previous experience as a senior investigator.
Previous experience utilizing QuickBase.
Proficient in researching information and identifying information resources.
Ability to utilize company systems to obtain relevant electronic documentation.
Ability to travel and participate in legal proceedings, arbitrations, depositions, etc.
Ability to interact with different groups of people at different levels and aid on a timely basis.
Previous experience working with a Third-Party Administrator (TPA) and/or Self-Funded Plans in an investigative capacity.
AHFI (Accredited Health Care Fraud Investigator), CFE (Certified Fraud Examiner), and/or CPC (Certified Professional Coder).
Knowledge of CVS/Aetna/Meritain Health’s policies and procedures

Education

Bachelor's Degree or equivalent work experience (high school diploma or GED + 4 years of relevant work experience).

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $122,400.00

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: 08/28/2026

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

claims jobs in charleston wv

Investigator, Special Investigations Unit (Meritain Health)

Claims Analyst - REMOTE

Administrative Services Assistant 1

Safety Officer

Charleston, WV (Psychiatrist or Psychologist with Office (vA))

Licensed Mental Health Therapist - Remote (LICSW, LPC)

Commercial Lines Account Manager

CDL A Lease Purchase Truck Driver - OTR

Pharmacy Order Entry Technician, Midshift

Security Officer - Walking Patrol

Casualty Claim Specialist I

Claims Investigator - Part Time

Medical Records Coder 1 -- Coding & Data Registry -- Document Center Building

Senior Claims Representative - REMOTE

Senior Claims Specialist - West Virginia

Registration Specialist- Internal Medicine Charleston

Medical Records Coder 1 -- Coding & Data Registry -- Document Center Building

(Hybrid) Health Data Analyst Senior - Health Affairs Institute

Registration Representative -- Cardiology South Charleston -- South Charleston- 4610 Kanawha Ave

Lead Director, Stop Loss Relationship Management

I want to receive the latest job alert for claims in charleston wv

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