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Insurance Investigator Jobs (NOW HIRING)

UnitedHealth Group

Insurance Investigator

Syracuse, NY · On-site

$18 - $32/hr

The Insurance Investigator is responsible for assisting patients with navigating their insurance benefits, cost of service and financial assistance needs. Individuals in this role serve as a liaison ...

UnitedHealth Group

Insurance Investigator

Syracuse, NY

$18 - $32/hr

The Insurance Investigator is responsible for assisting patients with navigating their insurance benefits, cost of service and financial assistance needs. Individuals in this role serve as a liaison ...

UnitedHealth Group

Insurance Investigator

Syracuse, NY

$18 - $32/hr

The Insurance Investigator is responsible for assisting patients with navigating their insurance benefits, cost of service and financial assistance needs. Individuals in this role serve as a liaison ...

Mentor Technical Group

Maintain accurate records of deviations, investigations, approvals, and follow-up activities. * Monitor deviation trends and provide reports to management to support continuous improvement ...

Ohio Jobs

Investigator Assistant

Cleveland, OH · On-site

$21.93/hr

Qualifications: 12 months experience as investigator/inspector (e.g., law enforcement officer, insurance investigator); valid driver's license. -Or 18 months training or 18 months experience in ...

Emerging Investigations

Private Investigator

Jacksonville, FL · On-site

$20.50 - $26.50/hr

Experience in insurance investigation and surveillance * Excellent written and verbal communication skills * Ability to work independently and remotely * Ability to work weekends and holidays as ...

Emerging Investigations

Private Investigator

Bradenton, FL · On-site

$20.25 - $25.75/hr

Experience in insurance investigation and surveillance * Excellent written and verbal communication skills * Ability to work independently and remotely * Ability to work weekends and holidays as ...

Emerging Investigations

Private Investigator

Orlando, FL · On-site

$20.75 - $26.50/hr

Experience in insurance investigation and surveillance * Excellent written and verbal communication skills * Ability to work independently and remotely * Ability to work weekends and holidays as ...

Reliant Medical Group

Insurance | , New York

Syracuse, NY · On-site

$18 - $32/hr

Insurance Investigator Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve ...

StateJobsNY

Internal Investigator 1 OPWDD

Manhattan, NY · On-site

$71K - $87K/yr

Insurance Investigator; Licensed and Registered Private Investigator; Federal Investigator; State Investigator; Municipal Investigator; Child Protective Services Investigator; Investigative position ...

New York State

Internal Investigator 1 OPWDD

Manhattan, NY · On-site

$71K - $87K/yr

Insurance Investigator; Licensed and Registered Private Investigator; Federal Investigator; State Investigator; Municipal Investigator; Child Protective Services Investigator; Investigative position ...

New York State

Investigator 1 (NY HELPS)

Manhattan, NY · On-site

$53K - $68K/yr

Experience in such positions as police detective, insurance investigator, licensed and registered private investigator, federal investigator, state investigator, municipal investigator, child ...

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Insurance Investigator information

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$13

$25

$38

How much do insurance investigator jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for insurance investigator in the United States is $25.77, according to ZipRecruiter salary data. Most workers in this role earn between $21.88 and $31.73 per hour, depending on experience, location, and employer.

What do insurance investigators do?

An insurance investigator works for an insurance company looking into insurance claims, usually when the claim may be fraudulent. As an insurance claims investigator, you gather information from the insurance adjuster, law enforcement, witnesses, and the claimant. You also make investigative inquiries to determine if the claim is valid or fraudulent. Your job is to document all evidence and present the case to your employer so that the insurance company is protected from false claims.

What are the key skills and qualifications needed to thrive as an insurance investigator, and why are they important?

To thrive as an Insurance Investigator, you need strong analytical skills, attention to detail, and a background in criminal justice, law, or a related field, often supported by a relevant degree or certification. Familiarity with case management software, database research tools, and surveillance equipment is typically required. Excellent communication, critical thinking, and integrity are crucial soft skills for interviewing witnesses and writing clear, objective reports. These abilities ensure accurate fraud detection, effective investigations, and compliance with legal standards in the insurance industry.

What are some of the common challenges faced by insurance investigators, and how can they be managed effectively?

Insurance Investigators often encounter challenges such as dealing with uncooperative claimants, navigating complex regulations, and managing a heavy caseload. Building strong communication and interpersonal skills can help when interviewing witnesses or claimants. Staying organized and up-to-date with the latest industry regulations ensures compliance and efficiency. Collaborating closely with claims adjusters, law enforcement, and legal teams also helps in resolving complex cases and maintaining workflow balance.

What is the difference between Insurance Investigator vs Claims Adjuster?

AspectInsurance InvestigatorClaims Adjuster
Required CredentialsLicenses, sometimes certifications in investigation or insuranceLicenses, certifications in claims handling or insurance
Work EnvironmentField investigations, interviews, surveillanceOffice-based, claims assessment, site visits
Employer & Industry UsageInsurance companies, private investigation firmsInsurance companies, third-party administrators
Common Search & ComparisonYesNo

Insurance Investigators focus on uncovering fraud and verifying claims through investigations, often working in the field. Claims Adjusters evaluate and settle insurance claims, primarily working in offices or on-site. While both roles require insurance knowledge and sometimes similar certifications, their daily tasks and work environments differ significantly.

What do you need to be an insurance investigator?

To become an insurance investigator, candidates typically need a high school diploma or equivalent, with some roles preferring or requiring a college degree in criminal justice, law enforcement, or a related field. Prior experience in law enforcement, claims adjusting, or related investigative work is often beneficial, along with strong analytical skills and knowledge of insurance policies. Licensing or certification may be required depending on the state or employer.
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Insurance Investigator jobs near you
Infographic showing various Insurance Investigator job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 20% Part Time, and 6% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $53,602 per year, or $25.8 per hour.

Insurance Investigator

UnitedHealth Group

Syracuse, NY • On-site

$18 - $32/hr

Full-time

Retirement

Re-posted 29 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

192nd of 896 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together.
This position is full-time, Mon-Fri 8:30am to 5pm. It may be necessary, given the business need, to work occasional overtime.
This is an on-site role at 1 Atwell Rd. Cooperstown, NY.
Primary Responsibilities:
The Insurance Investigator is responsible for assisting patients with navigating their insurance benefits, cost of service and financial assistance needs. Individuals in this role serve as a liaison between medical staff, patient financial services, insurance payers, patients, family members and other team members to ensure excellent patient care. This includes, but is not limited to the information outlined below:
  • Insurance
    • Verification of insurance eligibility, benefits, and authorizations
    • Ensure appropriate insurance coverage is listed within a patient's account
  • Financial Assistance & Enrollment
    • Point of contact for uninsured and underinsured patients
    • Collaborate with Patient Financial Services and various foundations for charity care
  • Assist eligible patients with enrolling for coverage on the exchange portal Estimates and Collections
  • Work with patients to set up payment plans and loan programs Customer Service
    • Collect confidential and sensitive information in a respectful manner
    • Assist patients, departments and providers with eligibility, benefits and authorization questions and cost information
    • Remain knowledgeable with changing workflows
  • Leadership
    • Navigate difficult conversations resourcefully and respectfully
    • Communicate protocols and complex terminology in a manner easy to understand
    • Motivate teammates to achieve goals set by department

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:
  • High School Diploma / GED
  • 1+ years of experience with Insurance benefit verification
  • 1+ years of practical work experience in healthcare or finance
  • Ability to work full-time, Mon-Fri 8:30am to 5pm
  • Ability to work an on-site role at 1 Atwell Rd. Cooperstown, NY

Preferred Qualifications:
  • 1 year of experience as an application counselor or navigator, or equivalent experience with New York State of Health
  • Experience with Microsoft Office products
  • Experience in a Hospital Patient Registration Department, Physician office or any medical setting
  • Working knowledge of medical terminology
  • Understanding of insurance policies and procedures
  • Experience in insurance reimbursement and financial verification
  • Ability to perform basic mathematics for financial payments
  • Experience in requesting and processing financial payments

Soft Skills:
  • Strong interpersonal, communication and customer service skills
  • Highly organized and ability to shift with changing priorities

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 hourly pay for this role will range from $18.00 to $32.00 per hour 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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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