Current jobs related to Investigator I - Norfolk, Virginia - Elevance Health

  • Investigator I

    4 weeks ago

    Norfolk, Virginia, United States Elevance Health Full time

    Job Title: Investigator IJob Summary:We are seeking a skilled Investigator I to join our team at Elevance Health. As an Investigator I, you will be responsible for investigating assigned cases, collecting and analyzing claim data to detect fraudulent, abusive, or wasteful activities.Key Responsibilities:Conduct thorough investigations of assigned cases,...

  • Investigator I

    4 weeks ago

    Norfolk, Virginia, United States Elevance Health Full time

    Job Title: Investigator IJob Summary:We are seeking a skilled Investigator I to join our team at Elevance Health. As an Investigator I, you will be responsible for investigating assigned cases, collecting and analyzing claim data to detect fraudulent, abusive, or wasteful activities.Key Responsibilities:Conduct thorough investigations of assigned cases,...

  • Investigator I

    2 weeks ago

    Norfolk, Virginia, United States Elevance Health Full time

    About the Role:This position will work in a hybrid model, with a mix of remote and office work. The ideal candidate will live within 50 miles of one of our Elevance Health locations.Carelon Payment Integrity is a proud member of the Elevance Health family of companies. Our team is dedicated to recovering, eliminating, and preventing unnecessary medical...

  • Investigator I

    2 months ago

    Norfolk, Virginia, United States Elevance Health Full time

    About the Role:We are seeking a skilled Investigator I to join our team at Elevance Health. As a key member of our organization, you will play a critical role in detecting and preventing healthcare fraud, abuse, and wasteful practices.Key Responsibilities:Conduct thorough investigations of assigned cases, analyzing claim data and reviewing professional and...

  • Police Officer I

    7 days ago

    Norfolk, Virginia, United States Eastern Virginia Medical School Full time

    Job SummaryWe are seeking a highly skilled and dedicated Police Officer I to join our team at Eastern Virginia Medical School. As a Police Officer I, you will be responsible for ensuring the safety and security of students, patients, visitors, staff, and property on campus.Key ResponsibilitiesPatrol and Security: Conduct routine patrols of the interior...

  • Police Officer I

    2 weeks ago

    Norfolk, Virginia, United States Eastern Virginia Medical School Full time

    Job SummaryWe are seeking a highly skilled and dedicated Police Officer I to join our team at Eastern Virginia Medical School. As a Police Officer I, you will be responsible for ensuring the safety and security of students, patients, visitors, staff, and property by patrolling assigned areas, maintaining traffic control, and investigating irregularities.Key...

  • Police Officer I Position

    4 weeks ago

    Norfolk, Virginia, United States Eastern Virginia Medical School Full time

    Job SummaryEastern Virginia Medical School is seeking a highly motivated and dedicated Police Officer I to join our team. As a Police Officer I, you will be responsible for maintaining a safe and secure environment for students, patients, visitors, staff, and property. This is an exciting opportunity to work in a dynamic and fast-paced environment, making a...

  • Mechanical Engineer I

    7 days ago

    Norfolk, Virginia, United States Bauer Compressors Full time

    The Design Engineer 1 performs engineering work requiring application of standard techniques, procedures, and criteria in carrying out a sequence of related engineering tasks.Limited exercise of judgment is required on details of work and in making preliminary selections and adaptations of engineering alternatives.For training and developmental purposes,...

  • Grievance and Appeals Manager

    7 days ago

    Norfolk, Virginia, United States Elevance Health Full time

    Job Summary:The Manager I Grievance/Appeals is responsible for management oversight of receipt, investigation, and processing associated with grievance and appeals ensuring regulatory compliance, quality, manages inventory and production levels, and operational and plan risk.Key Responsibilities:Serves as a functional resource expert and mentor to unit and...

  • Maritime Recruiter

    3 weeks ago

    Norfolk, Virginia, United States Adecco. Full time

    Job Title: PDS - Experienced Onsite Maritime RecruiterAbout the Role:The Onsite Recruiter will serve as the primary point of contact for client managers, contract employees, and candidates. This role is responsible for recruitment and management of associates at their designated client location.Key Responsibilities:Qualify requisitions with hiring managers...

  • Ship Superintendent

    7 days ago

    Norfolk, Virginia, United States A.P. Mller - Maersk AS Full time

    Job Title: Ship SuperintendentJob Summary: We are seeking a highly skilled and experienced Ship Superintendent to join our team at A.P. Moller - Maersk A/S. The successful candidate will be responsible for overseeing the day-to-day technical and operational issues related to assigned vessels.Key Responsibilities:Act as the primary point of contact with...

  • Tanker Port Engineer

    2 weeks ago

    Norfolk, Virginia, United States U.S. MARINE MANAGEMENT LLC Full time

    Tanker Port Engineer Job DescriptionU.S. Marine Management LLC is seeking a highly skilled Tanker Port Engineer to join our team. As a key member of our operations team, you will be responsible for overseeing the day-to-day technical and maintenance issues related to our tankers.Key Responsibilities:Advocate for shipboard safety and actively support timely...

  • Investigator I

    2 months ago

    Norfolk, United States Elevance Health Full time

    Job Description : Investigator I This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is...

  • Service Desk Specialist I

    1 month ago

    Norfolk, United States Towne Family of Companies Full time

    As a Service Desk Specialist, you may look forward to: Using automated tools to image workstations to departmental specifications Installing any client software or applications as needed Physically moving each completed system to the assigned office location Migration of user data, settings and applications from old hardware to new hardware Assisting with...

  • Independent Contractor Janitorial Services Newport News VA

    2 months ago

    Norfolk, United States City Wide Facility Solutions Full time

    City Wide Facility Solutions is the largest management company in the building maintenance industry, facilitating janitorial and more than 20 additional maintenance services for every client. But we do more than manage maintenance services for commercial facilities - we pride ourselves on being a partner that helps save time and solve problems! We are...

  • Wealth Advisor

    11 hours ago

    Norfolk, United States Old Point Financial Full time

    Description Position Summary: The Wealth Advisor is a registered representative responsible for client acquisition, growth and servicing by providing a balanced combination of professional investment management and personalized financial advice. The Wealth Advisor shares the organization's commitment to understand, care for, and guide financial decisions...

  • Registered Nurse

    2 months ago

    Norfolk, United States IntelyCare Full time

    Earn an hourly rate of up to $65 as a Registered Nurse (RN) in Franklin, MA (and the surrounding area), with the dual benefit of W2 employment and a flexible schedule that you control. That's right, at IntelyCare you get to choose your preferred shifts at any of our partner facilities and also what day, week —or even month — that you'd like to have off....

  • Senior Program Manager

    13 hours ago

    Norfolk, United States Alzheimer's Association Full time

    Description Position Summary: The purpose of this role is to implement the Alzheimer's Association's program delivery and growth strategy to reach more people with volunteer-delivered programs, especially in new, underrepresented and rural communities. The Manager is responsible for identifying, recruiting, engaging and growing volunteers and community...

  • Body Shop Technician I

    1 day ago

    South Norfolk, United States Penske Truck Leasing Full time

    Position Summary: As an experienced Body Shop Technician with Penske, you’ll use industry-leading technology and repair techniques – plus cutting-edge diagnostic equipment – to get our customers' state-of-the-art vehicles back up and running in high-quality condition. You’ll take the lead to perform minor and major truck and trailer...

  • Naval Communications SME

    5 days ago

    Norfolk, United States Booz Allen Hamilton Full time

    Naval Communications SMEThe Opportunity:As an expert in defense missions, your unique background inspires you to think bigger, push further, and ask questions others don’t. We need your extensive industry knowledge and advisory skills to solve some of our clients’ most complex problems and find solutions that keep our nation safe. As a communications and...

  • Construction Project Manager

    11 hours ago

    Norfolk, United States Dewberry Full time

    Job Description Dewberry is currently seeking a Construction Project Manager stationed out of the Richmond/Hampton, VA area Roads I-64 Corridor. Successful candidates will work remotely and on project sites in southeastern Virginia. The successful candidate will manage the assigned elements of a construction project to assure quality of the contractor’s...

  • PDS - Onsite Recruiter

    4 weeks ago

    Norfolk, United States Adecco. Full time

    Job DescriptionJob DescriptionAbout this roleSUMMARY:The Onsite Recruiter will serve as the first level of contact for client managers, contract employees and candidates.  This role is responsible for recruitment and management of associates at their designated client location.What you’ll be doingESSENTIAL DUTIES & RESPONSIBILITIES: Qualify requisitions...

  • Nuclear Medicine Technologist

    1 month ago

    Norfolk, Nebraska, United States Faith Regional Full time

    Job SummaryUnder the general supervision of the Director of Radiology Services, performs all nuclear medicine procedures, demonstrates anatomy under investigation through proper patient positioning, techniques selection, administration of radiopharmaceuticals, and application of immobilization and radiation protection devices according to policy and...

  • Tanker Port Engineer

    6 hours ago

    Norfolk, United States USMMI Full time

    U. S. Marine Management Position Description Disclaimer: - The purpose of this document is to provide a summary of the generic functions/tasks associated with this position. It is not an exhaustive or comprehensive list of all possible position responsibilities, tasks, and duties. The responsibilities, tasks, and duties of the incumbent might differ from...

  • Nuclear Med Tech

    1 month ago

    Norfolk, United States Faith Regional Full time

    Work Status Details: PRN | 8.00 Hours Every Two Weeks Exempt from Overtime: Non-Exempt Shift Details: Mon-Friday 7:15-15:30 Department: Nuclear Medicine | Reports To: Manager-Radiology The mission of Faith Regional Health Services is to serve Christ by providing all people with exemplary medical services in an environment of love and care. Summary: Under the...

Investigator I

2 months ago

Norfolk, Virginia, United States Elevance Health Full time

About the Role:

The Investigator I is a key member of our team at Elevance Health, responsible for investigating assigned cases to detect fraudulent, abusive, or wasteful activities in the healthcare insurance industry.

Key Responsibilities:

  • Conduct thorough investigations of claim data to identify potential fraud, abuse, or waste.
  • Analyze data and review professional and facility claims to detect suspicious activity.
  • Establish and maintain relationships with law enforcement agencies to facilitate collaboration and information sharing.
  • Develop and implement enterprise-wide investigations that impact multiple health plans, lines of business, and states.
  • Prepare statistical and financial analyses to document findings and maintain electronic case files.
  • Prepare final case reports and notification letters to providers.
  • Review and discuss settlement offers with management.

Requirements:

  • Bachelor's degree in a related field, such as healthcare administration, business, or a related field.
  • Minimum of 2 years of experience in healthcare insurance, law enforcement, or a related field.
  • Professional certifications, such as CFE, AHFI, or CPC, are preferred.

Preferred Skills:

  • Knowledge of healthcare policies and procedures.
  • Experience with Excel and other data analysis tools.
  • Understanding of managed care organizations and their operations.

About Elevance Health:

Elevance Health is a leading health company dedicated to improving lives and communities. We offer a range of benefits, including market-competitive total rewards, paid time off, and opportunities for professional growth and development.

Work Environment:

Elevance Health operates in a hybrid workforce strategy, with associates working at least one day per week at an Elevance Health location. Candidates must reside within 50 miles or a 1-hour commute of a relevant Elevance Health location.