Top 1075 Investigator i Jobs

Auditor/Investigator I
Qlarant —Remote
- $65,000 - $70,000 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Entry level
Quick Apply
Regulatory Affairs Specialist I
City of Hope —Remote
- $37.11 - $57.52 an hour
- Full-time
- Mid-level
- Master's degree
- Analysis skills
6d
AML Investigator I
Valley National Bank —Morristown, NJ
- $62,000 - $103,300 a year
- Microsoft Outlook
- Research
- Mid-level
Quick Apply
Investigator I
Health & Human Services Comm —Austin, TX
- $3,095.33 - $4,594.50 a month
- Overtime
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Opportunities for advancement
Quick Apply
Research Development Spec I, Vice President for Research (Remote)
UTMB Health —Galveston, TX
- Remote
- No experience needed
- Bachelor's degree
- Military encouraged
Central Study Coordinator I
Care Access —Remote
- $75,000 - $95,000 a year
- Remote
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- Paid holidays
Biostatistician I - CIBMTR
The Medical College of Wisconsin, Inc. —Milwaukee, WI
- Full-time
- Mid-level
- Master's degree
- Databases
- Paid parental leave
- Paid holidays
Quick Apply
C/S Forensic Investigator I
State of Delaware —Wilmington, DE
- Weekends as needed
- Background check
- Driver's License
- US work authorization
6d
Biostatistician 1
University of Miami —Miami, FL
- Full-time
- Mid-level
- Master's degree
- Analysis skills
- Health insurance
- Dental insurance
ME Investigator I
Travis County —Austin, TX
- $64,417.60 - $72,000.00 a year
- Weekends as needed
- Entry level
Contracts Analyst I - Grants & Contracts Office
The Medical College of Wisconsin, Inc. —Milwaukee, WI
- Full-time
- Office
- Master's degree
- University
- Paid parental leave
- Paid holidays
Quick Apply
4d
Biostatistical Consultant I, Internal Medicine
UT Southwestern —Dallas, TX
- Full-time
- Microsoft Excel
- Internal Medicine
- Mid-level
- Paid parental leave
- Paid holidays
ADMINISTRATOR I (Crime Gun Investigator)
State of Maryland - MSP - Office of the Superintendent —Baltimore County, MD
- $66,314 - $103,309 a year
- Online Application
- Bilingual
- High school
- Military
7d
Investigator I
ArcBest —Chicago, IL
- $56,000 - $73,000 a year
- Full-time
- Computer literacy
- Research
- Mid-level
Bioanalytical Principal Investigator- Scientist I Immunoassay
Resolian —Malvern, PA
- Full-time
- 7 years
- Bachelor of Science
- Bachelor's degree
5d
Research Assistant I - PHA-AFRRI
Henry M. Jackson Foundation —Bethesda, MD
- $19.33 - $24.00 an hour
- Full-time
- Entry level
- Health insurance
- Dental insurance
RESEARCH ASSOCIATE 1 OR 2
LSU Health Sciences Center New Orleans —New Orleans, LA
- Temporary
- Mid-level
- Master's degree
- University
- Paid holidays
- Dental insurance
Research Scientist I - Neurobiology
UTMB Health —Galveston, TX
- Medicine
- No experience needed
- Doctor of Philosophy
Investigator I - IV
State of Hawaii —Kailua-Kona, HI
- From $5,076 a month
- Email
- Background check
- Word processing
- Writing skills
- Mileage reimbursement
- Commuter assistance
Quick Apply
Clinical Research Nurse Specialist I-Cardiology Research
University Hospitals —Cleveland, OH
- $64,501 - $100,880 a year
- Nursing
- RN License
- BLS Certification

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Auditor/Investigator I

Qlarant -
Remote

Quick Apply

Job Details

Full-time
$65,000 - $70,000 a year

Qualifications

Stakeholder management

Full Job Description

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.

Best People, Best Solutions, Best Results

Job Summary:

Serves as an entry level professional who develops baseline plans for ensuring the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions. Adheres to industry regulations and company policies for managerial follow-up. Analyzes data in order to effectively assess the validity of claims. Provides accurate recommendations to management for claim resolution and closure. Documents and inputs all findings, while preparing comprehensive reports that may be used for legal or audit/investigative purposes.

Essential Functions:

Conducts routine and impartial audits/investigations into customer claims, ensuring accurate and fair assessments of claims validity.
Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed.
Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements.
Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities, safeguarding the integrity of the claims process.
Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives on claims.
Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards.
Ensures that all audit and investigative documents and records are processed into the database in a timely and accurate manner.
Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates.
Supports management in regular audit and investigation proceedings, ensuring full compliance with all applicable regional and federal standards, regulations, and protocols.

Level of Supervision Received:
Under general supervision, proceeds alone on regular duties, referring questionable cases to manager.

Education (can be substituted for experience):
Minimum Bachelor's Degree required

Work Experience (can be substituted for education):
0 - 2 years of experience required; 2 - 4 years preferred

Certification(s):
Certified Fraud Examiner or Accredited Healthcare Anti-Fraud Investigator preferred

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

Qlarant is a drug-free workplace. All offers of employment are contingent upon successful completion of pre-employment background and drug screens.

Quick Apply

Refine Your Search

investigator i jobs

Auditor/Investigator I

Regulatory Affairs Specialist I

AML Investigator I

Investigator I

Research Development Spec I, Vice President for Research (Remote)

Central Study Coordinator I

Biostatistician I - CIBMTR

C/S Forensic Investigator I

Biostatistician 1

ME Investigator I

Contracts Analyst I - Grants & Contracts Office

Biostatistical Consultant I, Internal Medicine

ADMINISTRATOR I (Crime Gun Investigator)

Investigator I

Bioanalytical Principal Investigator- Scientist I Immunoassay

Research Assistant I - PHA-AFRRI

RESEARCH ASSOCIATE 1 OR 2

Research Scientist I - Neurobiology

Investigator I - IV

Clinical Research Nurse Specialist I-Cardiology Research

I want to receive the latest job alert for investigator i

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