New Jersey Licensed Investigator III

A company is looking for an Investigator III to lead investigations within the Special Investigation Unit. Key Responsibilities Detects fraudulent activities by various parties, including subscribers and providers Decides on the most effective investigation methods for individual cases Prepares and documents fraud cases, including evidence assembly for potential legal action Required Qualifications, Training, and Education 7+ years of professional investigation experience in economic or insurance-related matters AHFI, CFE, and CPC certifications are required; medical field licensing is a plus In-depth knowledge of health insurance operations, including claims and enrollment Working knowledge of NJ criminal and civil law related to health insurance fraud Experience with investigative processes is required

May 16, 2025 - 21:46

A company is looking for an Investigator III to lead investigations within the Special Investigation Unit. Key Responsibilities Detects fraudulent activities by various parties, including subscribers and providers Decides on the most effective investigation methods for individual cases Prepares and documents fraud cases, including evidence assembly for potential legal action Required Qualifications, Training, and Education 7+ years of professional investigation experience in economic or insurance-related matters AHFI, CFE, and CPC certifications are required; medical field licensing is a plus In-depth knowledge of health insurance operations, including claims and enrollment Working knowledge of NJ criminal and civil law related to health insurance fraud Experience with investigative processes is required