Top 151 Investigator Jobs in West Virginia

Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —West Virginia
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Auditor/Investigator II
Qlarant —West Virginia
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Investigator
West Virginia Southern Federal Public Defender —Charleston, WV
- $74,678 - $163,514 a year
- Weekends as needed
- Background check
- Computer literacy
- Writing skills
7d
Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Charleston, WV
- $43,888 - $93,574 a year
- Full-time
- Microsoft Word
- Spanish
- Microsoft Excel
- Health insurance
- Dental insurance
Investigator 2
State of West Virginia —Kanawha County, WV
- $41,194 - $71,789 a year
- Full-time
- Management
- Mid-level
- Driver's License
3d
Senior Financial Investigator
Contact Government Services, LLC —Clarksburg, WV
- $65,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Contract Investigative Technician
ADC LTD NM —West Virginia
- Contract
- Mid-level
Quick Apply
Investigator 1
State of West Virginia —Martinsburg, WV
- $39,461 - $68,582 a year
- Email
- Background check
- Research
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Investigator
Ethos Risk Services —Morgantown, WV
- $25 - $35 an hour
- Part-time
- Mid-level
- Residential
- Driver's License
- Paid time off
- Referral program
Quick Apply
Investigator Associate
State of West Virginia —Martinsburg, WV
- $35,702 - $61,628 a year
- Email
- Background check
- Office
- Driver's License
- Health savings account
- Health insurance
Quick Apply
Field Claims Investigator
Phoenix Loss Control —Harrisville, WV
- $22 an hour
- Part-time
- Hybrid work
- Military
- Mid-level
- Analysis skills
Quick Apply
(Hybrid) Investigator - Talent and Culture
West Virginia University —Morgantown, WV
- Full-time
- Word processing
- University
- Travel
- Paid holidays
- Health insurance
11d
Background Investigator (FT Employee) - Morgantown, WV
Peraton —Morgantown, WV
- $26.07 an hour
- Full-time
- Writing skills
- Mid-level
- Office
- Health savings account
- Paid holidays
14d
Certified Professional Coder, Special Investigations Unit (Aetna SIU)
CVS Health —West Virginia
- $43,888 - $93,574 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
6d
Surveillance Investigator
Advantage Surveillance LLC —Charleston, WV
- $19 - $23 an hour
- Weekends as needed
- Clean driving record
- Pass drug screening
- Driving
- Travel reimbursement
- Paid parental leave
Quick Apply
Child Abuse & Exploitation Investigation Specialist
City of Parkersburg —Parkersburg, WV
- $36,506.00 - $52,565.76 a year
- Full-time
- Background check
- Management
- 5 years
- Health insurance
- Dental insurance
Quick Apply
5d
Claims Investigator - Part Time
Command Investigations, LLC —Charleston, WV
- $23 - $30 an hour
- Overtime
- Microsoft Excel
- Microsoft Outlook
- Customer service
Quick Apply
12d
Clinical Trial Manager - Full Service
サイネオス・ヘルス —West Virginia
- Remote
- Computer literacy
- Bachelor's degree
- Travel
- Employee stock purchase plan
- Health insurance
4d
(Temporary) Clinical Research Coordinator Certificate Trainee - WV Clinical & Translational Science Institute
West Virginia University —Morgantown, WV
- Part-time
- Nursing
- Patient monitoring
- Writing skills
Surveillance Investigator II - Experienced
Command Investigations, LLC —Morgantown, WV
- $25 - $30 an hour
- 8 hour shift
- Microsoft Word
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
Quick Apply

I want to receive the latest job alert for investigator in west virginia

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

investigator jobs near west virginia

Clinical Research Coordinator jobs in Morgantown, WV

Clinical Trial Manager jobs in Morrisville, NC

Surveillance Investigator jobs in Charleston, WV

Siu Investigator jobs in Doral, FL

Siu Investigator jobs in Providence, RI

Background Investigator jobs in Arizona

Private Investigator jobs in Ohio

Siu Investigator jobs in Stuart, FL

Crime Scene Investigator jobs in San Antonio, TX

Siu Investigator jobs in Nashville, TN

Investigator jobs in Oregon

Field Investigator jobs in Dallas Fort Worth, TX

Private Investigator jobs in California

Field Investigator jobs in New York, NY

Criminal Investigator jobs in Boston, MA

Field Investigator jobs in Raleigh Durham, NC

Field Investigator jobs in Arden Hills, MN

Real Estate Transaction Coordinator jobs in Seattle, WA

Clinical Pharmacist jobs in Pittsburgh, PA

Clinical Research Coordinator jobs in Wichita, KS

Senior Investigator, Special Investigations Unit (Aetna SIU)

CVS Health -
West Virginia

Apply Now

Job Details

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

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Healthcare financial misconduct investigations
Customer communication
Spreadsheets
Research
Suspicious activity investigations
HCPCS
Insurance investigations
Productivity software

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.

Position Summary

As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple perpetrators or intricate healthcare fraud schemes.

Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business
Researches and prepares cases for clinical and legal review
Documents all appropriate case activity in case tracking system
Facilitates feedback with providers related to clinical findings
Initiates proactive data mining to identify aberrant billing patterns
Makes referrals, both internal and external, in the required timeframe
Facilitates the recovery of company and customer money lost as a result of fraud matters
Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators.
Assists Investigators in identifying resources and best course of action on investigations
Serves as back up to the Team Leader as necessary
Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters.
Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings
Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach to fighting fraud
Provides input regarding controls for monitoring fraud related issues within the business units

Required Qualifications

3+ years investigative experience in the area of healthcare fraud and abuse matters.

Working knowledge of medical coding; CPT, HCPCS, ICD10
Experience with Microsoft Office with advanced skills in Excel (must know how to do pivot tables).
Ability to travel up to 10% (approx. 2-3x per year, depending on business needs)

Preferred Qualifications

Previous Medicaid/Medicare investigatory experience
Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations for fraud and abuse.
Credentials such as certification from the Association of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti-Fraud Association (AHFI)
Knowledge of Aetna's policies and procedures.
Knowledge and understanding of complex clinical issues.
Competent with legal theories.
Strong communication and customer service skills.
Ability to effectively interact with different groups of people at different levels in any situation.
Strong analytical and research skills.
Proficient in researching information and identifying information resources.
Strong verbal and written communication skills.

Education:

Bachelor's degree or equivalent experience (3+ years of working health care fraud, waste and abuse investigations).

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: 08/01/2026

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

investigator jobs in west virginia

Senior Investigator, Special Investigations Unit (Aetna SIU)

Auditor/Investigator II

Investigator

Investigator, Special Investigations Unit (Aetna SIU)

Investigator 2

Senior Financial Investigator

Contract Investigative Technician

Investigator 1

Investigator

Investigator Associate

Field Claims Investigator

(Hybrid) Investigator - Talent and Culture

Background Investigator (FT Employee) - Morgantown, WV

Certified Professional Coder, Special Investigations Unit (Aetna SIU)

Surveillance Investigator

Child Abuse & Exploitation Investigation Specialist

Claims Investigator - Part Time

Clinical Trial Manager - Full Service

(Temporary) Clinical Research Coordinator Certificate Trainee - WV Clinical & Translational Science Institute

Surveillance Investigator II - Experienced

I want to receive the latest job alert for investigator in west virginia

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected