Top 44 Claims investigator Jobs in Nebraska

Investigator- Remote in Nebraska
UnitedHealthcare —Omaha, NE
- $49,700 - $88,800 a year
- Full-time
- Remote
- Microsoft Word
- Pass drug screening
- Analysis skills
- AD&D insurance
- Employee stock purchase plan
Property Damage Specialist II
JNR Adjustment Company, Inc. —Omaha, NE
- $20 - $24 an hour
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Sr Claims Specialist | Liability Bodily Injury
Great West, an Old Republic Company —South Sioux City, NE
- Customer service
- 5 years
- Analysis skills
Quick Apply
3d
Investigator
Ethos Risk Services —Omaha, NE
- $40 - $60 an hour
- Weekends as needed
- Mid-level
- Residential
- Driver's License
- Disability insurance
- Health insurance
Quick Apply
Hybrid Investigator
Frasco Inc —Lincoln, NE
- $18 - $30 an hour
- Weekends as needed
- Hybrid work
- Clean driving record
- Customer service
- Military
- Paid training
- Mileage reimbursement
3d
Claims Investigator - Part Time
Command Investigations, LLC —Omaha, NE
- $23 - $30 an hour
- Overtime
- Remote
- Microsoft Excel
- Microsoft Outlook
- Customer service
Quick Apply
SIU Claims Investigator
Lemieux & Associates LLC —Omaha, NE
- $25 - $32 an hour
- Part-time
- Bilingual
- Computer literacy
- Mid-level
- Flexible schedule
Quick Apply
Provider Fraud Investigator
State of Nebraska —Lincoln, NE
- $25.61 an hour
- Full-time
- Mid-level
- Office
- Analysis skills
- Paid time off
7d
Medical Claims Specialist (entry level)
Omaha National —Omaha, NE
- Bachelor's degree
- Communication skills
- Entry level
- Paid parental leave
- 401(k)
5h
Investigator, Special Investigative Unit-Nebraska
Molina Healthcare —Nebraska
- $20.73 - $42.55 an hour
- Full-time
- Anatomy knowledge
- Customer service
- Research
- Health insurance
Field Claims Investigator
Phoenix Loss Control —Omaha, NE
- $25 an hour
- Part-time
- Hybrid work
- Military
- Mid-level
- Analysis skills
Quick Apply
Claims Supervisor
Werner Enterprises —Omaha, NE
- Full-time
- Research
- Mid-level
- Office
- Employee stock purchase plan
- Disability insurance
14d
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Lincoln, NE
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
SIU Analyst
Argo Group —Omaha, NE
- Full-time
- Customer service
- English
- Research
- Health insurance
- Dental insurance
10d
PROPERTY CLAIMS ADJUSTER-NORTHEAST NEBRASKA (NORFOLK, COLUMBUS, And SIOUX CITY)
Grinnell Mutual Reinsurance —Norfolk, NE
- $50,997.68 - $101,766.79 a year
- Full-time
- Mid-level
- Office
- Ability to lift 50 pounds
- Paid holidays
- Disability insurance
Certified Professional Coder, Special Investigations Unit (Aetna SIU)
CVS Health —Nebraska
- $43,888 - $93,574 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
Fraud and Abuse Investigator / CPC - Remote
Sentara Workforce Solutions, LLC —Norfolk, NE
- $25.60 - $42.67 an hour
- Overtime
- Remote
- Mid-level
- Bachelor's degree
- 2 years
- 403(b) matching
- Paid parental leave
Quick Apply
1d
Surveillance Investigator
Allied Universal® Compliance and Investigations —Omaha, NE
- Weekends as needed
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
14d
Auditor
Amentum —Omaha, NE
- $80,000 - $108,000 a year
- Full-time
- CPA
- GAAP
- Senior level
- Employee stock purchase plan
- Paid holidays
Surveillance Agent
Marshall Investigative Group —Omaha, NE
- $22 - $32 an hour
- Part-time
- Microsoft Word
- 11+ years
- Research
Quick Apply

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claims investigator jobs near nebraska

Investigator- Remote in Nebraska

UnitedHealthcare -
Omaha, NE

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Job Details

Full-time
$49,700 - $88,800 a year

Benefits

AD&D insurance
Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
Employee discount
Referral program
Pet insurance

Qualifications

Microsoft Word
Spreadsheets
Word embeddings

Full Job Description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts on the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Investigator is responsible for identifying, investigating, and preventing healthcare fraud, waste, and abuse (FWA). This role leverages claims data analysis, regulatory guidelines, and investigative methodologies to detect suspicious billing patterns and activities. The Investigator conducts thorough investigations, which may include fieldwork such as interviews and evidence collection, and ensures compliance with applicable regulatory requirements.

Schedule: Monday - Friday 8:00am - 4:30pm

If you reside in the state of Nebraska, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

Assess and triage allegations of misconduct received within the organization
Conduct investigations of low- to moderately complex fraud, waste, and abuse cases involving members, providers, employees, and third parties
Identify potential fraudulent activities through data analysis, trend identification, and investigative techniques
Develop and execute efficient, case-specific investigative strategies
Maintain accurate, complete, and timely case documentation within the SIU case management system
Gather, preserve, and analyze evidence; prepare clear and concise investigative summaries and reports
Support settlement negotiations and provide documentation for legal or recovery actions
Analyze referral data to identify patterns, trends, and emerging risks
Ensure adherence to all applicable federal and state regulations, contractual obligations, and company policies
Report suspected fraud, waste, and abuse to appropriate regulatory agencies as required
Collaborate with internal teams and external partners, including state and federal agencies, as directed by SIU leadership
Participate in regulatory meetings, workgroups, and cross-functional initiatives
Communicate findings effectively through written reports and verbal presentations
Establish and manage investigation goals, monitor progress, and adjust priorities as needed
Participate in legal proceedings, including depositions, arbitration, and court testimony, as required

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
More information can be downloaded at: http://uhg.hr/uhgbenefits

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Bachelor's degree or Associate's Degree with 2+ years of equivalent work experience
Ability to travel up to 25% as required
Intermediate level of proficiency in Microsoft Excel and Word

Preferred Qualifications:

Experience in healthcare fraud, waste, and abuse investigations or auditing
Knowledge of federal and state healthcare regulations related to FWA
Experience with data analysis and trend identification in healthcare claims
Formal training in healthcare fraud investigations
National Health Care Anti-Fraud Association (NHCAA) affiliation
Accredited Health Care Fraud Investigator (AHFI)
Certified Fraud Examiner (CFE)
Certified Professional Coder (CPC)
Medical Laboratory Technician (MLT)
Knowledge of investigative techniques and evidence handling practices

Soft Skills:

Strong analytical and problem-solving skills
Ability to interpret complex data and identify irregular patterns
Effective written and verbal communication skills
Strong organizational skills with the ability to manage multiple investigations simultaneously

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $49,700 to $88,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN

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Refine Your Search

claims investigator jobs in nebraska

Investigator- Remote in Nebraska

Property Damage Specialist II

Sr Claims Specialist | Liability Bodily Injury

Investigator

Hybrid Investigator

Claims Investigator - Part Time

SIU Claims Investigator

Provider Fraud Investigator

Medical Claims Specialist (entry level)

Investigator, Special Investigative Unit-Nebraska

Field Claims Investigator

Claims Supervisor

Investigator, Special Investigations Unit (Meritain Health)

SIU Analyst

PROPERTY CLAIMS ADJUSTER-NORTHEAST NEBRASKA (NORFOLK, COLUMBUS, And SIOUX CITY)

Certified Professional Coder, Special Investigations Unit (Aetna SIU)

Fraud and Abuse Investigator / CPC - Remote

Surveillance Investigator

Auditor

Surveillance Agent

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