CoventBridge Group

Role Description The Data Analyst II will play a key role in detecting, analyzing, and reporting patterns of healthcare fraud, waste, and abuse. They will perform in-depth evaluation and analysis of potential fraud cases and requests for information using claims information and other sources of data. The ideal candidate will have a strong background in healthcare claim analytics, a deep understanding of fraud, waste and abuse schemes, and the ability to translate analytic findings into actionable insights for investigators, clients, and stakeholders. In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse. The Data Analyst II position will report to the Data Solutions Supervisor and will work remotely from a home office. Responsibilities - Work with management, investigators, and the data team to provide key statistical research, analytics, and reporting functions for innovative case development support and to fulfill health plan client and/or law enforcement data requests. - Utilize data analysis techniques such as data mining, statistical modeling, predictive modeling, etc. to detect aberrancies in health plan claims data, and proactively seeks out and develops leads and cases received from a variety of sources including a health plan client, CMS, OIG, fraud alerts, and referrals from government and private sources. - Communicate effectively with internal and external stakeholders. - Validate analytic results and identify potential fraud, waste and/or abuse situations in violation of private, state, and/or federal laws, guidelines, policies, and/or regulations. - Support management requests for client reporting requirements. - Prepare, develop, and participate in provider, law enforcement, or staff training as related to health plan insurance products including but not limited to Commercial, Medicare, Medicaid, ACA/Exchange, FEHB, and Tricare fraud, waste and abuse data analysis. - Maintain chain of custody on all documents and follow all confidentiality and security guidelines. - Create dashboards and visualizations in Tableau, Power BI, or Sigma to communicate findings. - Experience working in an enterprise analytics platform. - Perform other duties as assigned and agreed upon. - Write efficient, production-quality code in Python, R, and SQL for data cleaning, transformation, and modeling. Qualifications - Effective communication skills (verbal and written) to interpret data outcomes. - High proficiency level with MS Word and Excel. - Proficiency with database and analytic programming languages such as SQL, Python, R and/or other applications to perform diverse types of data analysis and/or data science. - Strong critical thinking and problem-solving skills. - Knowledge of Medicare and Medicaid rules and regulation is a plus. - Strong organizational skills and the ability to effectively manage workload within the established timelines. - Demonstrated knowledge of various database management systems in order to input, extract or manipulate information. - Understanding of healthcare claims processes- solid understanding of health claims fields, claim types, payers, reimbursement models and regulatory requirements. - Comfortable with utilizing AI assisted development tools. - Experience with GitHub, GitLab, or other Git technology. Requirements - Minimum of a Bachelor’s degree in Mathematics, Statistics, Healthcare Administration, Data Science, or related discipline with preference given to MA or MS recipients, and/or relevant work experience as a data analyst (Or similar position). - 3+ years of experience analyzing healthcare claims data in fraud, waste, and abuse investigations. - Experience with data visualization tools such as Tableau, Power BI, or Sigma is a plus. - Experience in handling large data sets and relational databases. - Experience and knowledge of healthcare information (health claims data; specifically, ICD-9-CM and ICD-10-CM codes, CPT, HCPCS, DRG, 837P, etc.) is required. Benefits - Medical, Dental, Vision plans. - Life, LTD and STD paid by the employer. - 401(k) with company match up to 4%. - Paid Time Off and company paid holidays. - Tuition assistance after 1 year of service. - The salary range for this role is $65,000 to $75,000 annually.

Role Description As a Desktop Investigator, you will conduct investigative assignments primarily by phone and online research. Depending on the assignment, the employee may perform a combination of some or all of the following duties: - Review case documentation, client instructions, and prior reports to plan investigative strategies. - Conduct research using public and private databases, social media, and open-source tools. - Make up to 75 outbound calls per day to collect information from medical providers, employers, and third parties. - Support field investigators with insights, updates, and case coordination. - Write detailed, accurate, and unbiased reports that clearly document findings and conclusions. - Maintain organized, up-to-date records within the case management system. Every case presents a new challenge — and your work will directly impact client outcomes. Qualifications - Hold or qualify for a valid Private Investigator’s License (as required by state). - Communicate clearly and professionally in both written and verbal formats. - Demonstrate persistence and professionalism when speaking with third parties. - Analyze and interpret complex or conflicting information with accuracy. - Prioritize multiple cases while maintaining attention to detail and deadlines. - Work independently with integrity, initiative, and sound judgment. Requirements - Earned an associate’s degree or higher. - Understand basic medical terminology or have exposure to the healthcare industry. - Thrived in a fast-paced, high-volume investigative environment. Benefits - Base Rate: $18.00/hr - Company Paid Training - Remote Work Flexibility - Medical, Dental, Vision Insurance - Company-paid Life, LTD and STD Insurance - 401(k) with 4% Company Match - Paid Time Off with Company Paid Holidays - Tuition Assistance After 1 Year

Title: Desktop Investigator Location: US-MI-Grand Rapids Job ID 2026-6143 Category Investigations Overview Desktop Investigator - Remote Full-Time / Hourly Uncover the Story Behind Every Claim At CoventBridge Group, every case tells a story — and as a Desktop Investigator, you’ll be the one uncovering the truth. From your home office, you’ll dig into insurance and fraud investigations using research tools, phone work, and your own investigative instincts. Join the global leader in full-service investigations — where precision, integrity, and curiosity drive everything we do. At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.) Responsibilities/ Requirements What You’ll Do As a Desktop Investigator, you will conduct investigative assignments primarily by phone and online research. Depending on the assignment, the employee may perform a combination of some or all of the following duties: · Review case documentation, client instructions, and prior reports to plan investigative strategies. · Conduct research using public and private databases, social media, and open-source tools. · Make up to 75 outbound calls per day to collect information from medical providers, employers, and third parties. · Support field investigators with insights, updates, and case coordination. · Write detailed, accurate, and unbiased reports that clearly document findings and conclusions. · Maintain organized, up-to-date records within the case management system. Every case presents a new challenge — and your work will directly impact client outcomes. Requirements Basic Qualifications: · Hold or qualify for a valid Private Investigator’s License (as required by state). · Communicate clearly and professionally in both written and verbal formats. · Demonstrate persistence and professionalism when speaking with third parties. · Analyze and interpret complex or conflicting information with accuracy. · Prioritize multiple cases while maintaining attention to detail and deadlines. · Work independently with integrity, initiative, and sound judgment. Preferred Qualifications: · Earned an associate’s degree or higher. · Understand basic medical terminology or have exposure to the healthcare industry. · Thrived in a fast-paced, high-volume investigative environment. Benefits Compensation & Benefits: We invest in our employees because great work requires great rewards. Here’s what you can expect when you join our team: · Base Rate: $18.00/hr · Company Paid Training · Remote Work Flexibility · Medical, Dental, Vision Insurance · Company-paid Life, LTD and STD Insurance · 401(k) with 4% Company Match · Paid Time Off with Company Paid Holidays · Tuition Assistance After 1 Year The hourly rate for this role is $18 per hour. This is the highest rate we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs. Pursuant to the respective Fair Chance Ordinances of both Los Angeles and San Francisco, we will consider for employment qualified applicants with arrest and conviction records. About Us: CoventBridge Group is a global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 700+ employees and affiliates worldwide. CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace. CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com. https://coventbridge.com/licensing/ Apply for this job online Email this job to a friend Share on your newsfeed

Role Description As a Claims Investigator, you’ll combine analytical skill with real-world investigation techniques to uncover facts, document findings, and deliver objective results. You will: - Conduct complex field investigations involving multiple claim types. - Submit daily updates summarizing your progress and observations. - Manage your time effectively to maintain client billable hour expectations. - Write detailed, professional statements and investigative summaries. - Deliver clear, client-ready reports that meet CoventBridge’s quality standards. - Perform scene investigations, background checks, and courthouse research. - Operate safely and remain alert while driving during field assignments. Your curiosity and persistence will turn each case into a story built on truth and evidence. Qualifications - Hold a valid (state) Investigator license (or eligibility for licensure in surrounding states). - Demonstrate at least 1 year of field investigations experience, including face-to-face statements and report writing. - Travel across multiple states as needed to complete case assignments. - Investigate claims related to product, auto, general liability, Workers’ Compensation, disability, life insurance, and contestable death cases. - Adapt to variable schedules — including nights and weekends when required. - Maintain a reliable, fuel-efficient vehicle and required insurance coverage. - Equip yourself with a digital recorder, laptop (Windows OS), and necessary investigative tools. Requirements - A minimum of 3-5 years of Claims, SIU, or adjusting experience. - An Associate’s or Bachelor’s degree in Criminal Justice or a related field. - Strong report writing skills. - Understand investigative processes, insurance law, and claim procedures. - Excel in report writing and typing (50+ WPM) with accuracy and attention to detail. - Thrive under pressure and maintain professionalism in sensitive situations. - Demonstrate self-motivation, accountability, and sound judgment. Benefits - Home-based work and flexible scheduling. - Competitive pay with monthly vehicle allowance. - Paid time off. - Company fuel card and company-issued cell phone. - Medical, Dental, Vision plans. - Employer-paid Life, LTD, STD insurance. - 401(k) with company match. - Travel and report writing compensation. - Licensing fees paid by company. - Paid ongoing career advancement training. - Expense reimbursement with minimal out-of-pocket expenses. The salary range for this role is $28-$31 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs. Pursuant to the respective Fair Chance Ordinances of both Los Angeles and San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Role Description Are you a licensed healthcare professional (RN or NP) with a passion for uncovering the truth behind medical claims? We’re seeking an experienced Investigative Clinician to join our team and support a major national client in evaluating the medical validity of insurance claims. This role blends clinical expertise with investigative acumen to detect, prevent, and resolve fraudulent, exaggerated, or non-medically necessary claims. As an integral member of the Special Investigations Unit (SIU), you’ll collaborate closely with adjusters, legal teams, and investigators to analyze medical documentation and uncover inconsistencies or red flags. If you thrive in a fast-paced, analytical environment and want to make a real impact in the fight against insurance fraud, we want to hear from you. Qualifications - Active U.S. license as a healthcare professional (RN, NP, MD, or equivalent, no LPN's). - At least 3–5 years of hands-on clinical experience. - Prior work experience in insurance claims review, utilization management, or healthcare fraud investigation highly preferred. - Proficient in reviewing electronic health records (EHRs), ICD-10, CPT coding, and medical billing practices. - Exceptional critical thinking, detail orientation, and analytical skills. - Strong verbal and written communication skills, including report writing. - Ability to work independently and manage multiple concurrent assignments in a remote environment. Requirements - Conduct thorough reviews of medical records, treatment plans, and billing documentation to assess accuracy, consistency, and medical necessity. - Identify patterns of overutilization, upcoding, or potential fraud and abuse. - Provide clinical expertise to claims investigators, legal personnel, and other stakeholders in evaluating questionable claims. - Interview claimants, healthcare providers, and related parties as needed to clarify details and verify medical facts. - Prepare clear, detailed, and objective clinical summary reports with findings and recommendations. - Deliver expert clinical opinions regarding treatment appropriateness and outcomes. - Remain up-to-date with current clinical practices, fraud trends, billing guidelines, and relevant regulations. - Participate in depositions or testify as a clinical expert in support of litigation efforts, when required. Benefits - Career development training - Medical, Dental, Vision plans - Life, LTD and STD paid by the employer - 401(k) with company match - Paid vacation - Paid Paternity/Maternity Leave, after 1 year of service - Tuition assistance after 1 year of service The salary range for this role is between $80,000.00 - $110,000.00 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.

Overview Claims Investigator – Part Time Jacksonville, FL Uncover the Truth. Protect the Integrity. Advance Your Career. At CoventBridge Group, every claim tells a story — and as a Claims Investigator, you’ll be the one uncovering it. Using your investigative instincts, field experience, and attention to detail, you’ll help clients get the answers they need and ensure claims are resolved with accuracy and fairness. Join a global leader in full-service investigations, where integrity meets action, and every day brings a new case — and a new challenge. At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.) Responsibilities/ Requirements What You’ll Do: As a Claims Investigator, you’ll combine analytical skill with real-world investigation techniques to uncover facts, document findings, and deliver objective results. You will: · Conduct complex field investigations involving multiple claim types. · Submit daily updates summarizing your progress and observations. · Manage your time effectively to maintain client billable hour expectations. · Write detailed, professional statements and investigative summaries. · Deliver clear, client-ready reports that meet CoventBridge’s quality standards. · Perform scene investigations, background checks, and courthouse research. · Operate safely and remain alert while driving during field assignments. Your curiosity and persistence will turn each case into a story built on truth and evidence. What You’ll Bring: We’re looking for investigators who are driven, professional, and dedicated to uncovering facts with accuracy and integrity. · Hold a valid (state) Investigator license (or eligibility for licensure in surrounding states). · Demonstrate at least 1 year of field investigations experience, including face-to-face statements and report writing. · Travel across multiple states as needed to complete case assignments. · Investigate claims related to product, auto, general liability, Workers’ Compensation, disability, life insurance, and contestable death cases. · Adapt to variable schedules — including nights and weekends when required. · Maintain a reliable, fuel-efficient vehicle and required insurance coverage. · Equip yourself with a digital recorder, laptop (Windows OS), and necessary investigative tools. What You’ll Need: To qualify for this position, applicants must possess the following: · A minimum of 3-5 years of experience in Claims, SIU, or adjusting. · An Associate’s or Bachelor’s degree in Criminal Justice or a related field. · Strong report writing skills. · Understand investigative processes, insurance law, and claim procedures. · Excel in report writing and typing (50+ WPM) with accuracy and attention to detail. · Thrive under pressure and maintain professionalism in sensitive situations. · Demonstrate self-motivation, accountability, and sound judgment. Benefits We believe great work deserves great rewards. Here’s what you can expect when you join our team: · Home-based work and flexible scheduling · Competitive pay with monthly vehicle allowance · Company fuel card and company-issued cell phone · Employer-paid Life, LTD, STD insurance · 401(k) with company match · Travel and report writing compensation · Licensing fees paid by company · Paid ongoing career advancement training · Expense reimbursement with minimal out-of-pocket expenses About Us: CoventBridge Group is a global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 700+ employees and affiliates worldwide. CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace. CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com. CoventBridge Group Inc. Florida License # A1000233

Overview Claims Investigator – Full Time Seattle, WA Uncover the Truth. Protect the Integrity. Advance Your Career. At CoventBridge Group, every claim tells a story — and as a Claims Investigator, you’ll be the one uncovering it. Using your investigative instincts, field experience, and attention to detail, you’ll help clients get the answers they need and ensure claims are resolved with accuracy and fairness. Join a global leader in full-service investigations, where integrity meets action, and every day brings a new case — and a new challenge. At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.) Responsibilities/ Requirements What You’ll Do: As a Claims Investigator, you’ll combine analytical skill with real-world investigation techniques to uncover facts, document findings, and deliver objective results. You will: · Conduct complex field investigations involving multiple claim types. · Submit daily updates summarizing your progress and observations. · Manage your time effectively to maintain client billable hour expectations. · Write detailed, professional statements and investigative summaries. · Deliver clear, client-ready reports that meet CoventBridge’s quality standards. · Perform scene investigations, background checks, and courthouse research. · Operate safely and remain alert while driving during field assignments. Your curiosity and persistence will turn each case into a story built on truth and evidence. What You’ll Bring: We’re looking for investigators who are driven, professional, and dedicated to uncovering facts with accuracy and integrity. · Hold a valid (state) Investigator license (or eligibility for licensure in surrounding states). · Demonstrate at least 1 year of field investigations experience, including face-to-face statements and report writing. · Travel across multiple states as needed to complete case assignments. · Investigate claims related to product, auto, general liability, Workers’ Compensation, disability, life insurance, and contestable death cases. · Adapt to variable schedules — including nights and weekends when required. · Maintain a reliable, fuel-efficient vehicle and required insurance coverage. · Equip yourself with a digital recorder, laptop (Windows OS), and necessary investigative tools. What You’ll Need: To qualify for this position, applicants must possess the following: · A minimum of 3-5 years of Claims, SIU, or adjusting experience. · An Associate’s or Bachelor’s degree in Criminal Justice or a related field. · Strong report writing skills. · Understand investigative processes, insurance law, and claim procedures. · Excel in report writing and typing (50+ WPM) with accuracy and attention to detail. · Thrive under pressure and maintain professionalism in sensitive situations. · Demonstrate self-motivation, accountability, and sound judgment. Benefits Benefits We believe great work deserves great rewards. Here’s what you can expect when you join our team: · Home-based work and flexible scheduling · Competitive pay with monthly vehicle allowance · Paid time off · Company fuel card and company-issued cell phone · Medical, Dental, Vision plans · Employer-paid Life, LTD, STD insurance · 401(k) with company match · Travel and report writing compensation · Licensing fees paid by company · Paid ongoing career advancement training · Expense reimbursement with minimal out-of-pocket expenses The salary range for this role is $27-$30 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs. About Us: CoventBridge Group is a global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 700+ employees and affiliates worldwide. CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace. CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com. CoventBridge (USA) Inc. Washington License # 1844

Overview Claims Investigator – Part Time Olympia, WA Uncover the Truth. Protect the Integrity. Advance Your Career. At CoventBridge Group, every claim tells a story — and as a Claims Investigator, you’ll be the one uncovering it. Using your investigative instincts, field experience, and attention to detail, you’ll help clients get the answers they need and ensure claims are resolved with accuracy and fairness. Join a global leader in full-service investigations, where integrity meets action, and every day brings a new case — and a new challenge. At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.) Responsibilities/ Requirements What You’ll Do: As a Claims Investigator, you’ll combine analytical skill with real-world investigation techniques to uncover facts, document findings, and deliver objective results. You will: · Conduct complex field investigations involving multiple claim types. · Submit daily updates summarizing your progress and observations. · Manage your time effectively to maintain client billable hour expectations. · Write detailed, professional statements and investigative summaries. · Deliver clear, client-ready reports that meet CoventBridge’s quality standards. · Perform scene investigations, background checks, and courthouse research. · Operate safely and remain alert while driving during field assignments. Your curiosity and persistence will turn each case into a story built on truth and evidence. What You’ll Bring: We’re looking for investigators who are driven, professional, and dedicated to uncovering facts with accuracy and integrity. · Hold a valid (state) Investigator license (or eligibility for licensure in surrounding states). · Demonstrate at least 1 year of field investigations experience, including face-to-face statements and report writing. · Travel across multiple states as needed to complete case assignments. · Investigate claims related to product, auto, general liability, Workers’ Compensation, disability, life insurance, and contestable death cases. · Adapt to variable schedules — including nights and weekends when required. · Maintain a reliable, fuel-efficient vehicle and required insurance coverage. · Equip yourself with a digital recorder, laptop (Windows OS), and necessary investigative tools. What You’ll Need: To qualify for this position, applicants must possess the following: · A minimum of 3-5 years of experience in Claims, SIU, or adjusting. · An Associate’s or Bachelor’s degree in Criminal Justice or a related field. · Strong report writing skills. · Understand investigative processes, insurance law, and claim procedures. · Excel in report writing and typing (50+ WPM) with accuracy and attention to detail. · Thrive under pressure and maintain professionalism in sensitive situations. · Demonstrate self-motivation, accountability, and sound judgment. Benefits We believe great work deserves great rewards. Here’s what you can expect when you join our team: · Home-based work and flexible scheduling · Competitive pay with monthly vehicle allowance · Company fuel card and company-issued cell phone · Employer-paid Life, LTD, STD insurance · 401(k) with company match · Travel and report writing compensation · Licensing fees paid by company · Paid ongoing career advancement training · Expense reimbursement with minimal out-of-pocket expenses The salary range for this role is $27-$30 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs. About Us: CoventBridge Group is a global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 700+ employees and affiliates worldwide. CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace. CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com. CoventBridge (USA) Inc. Washington License # 1844

Overview Surveillance Investigator - Full Time Bronx, NY Area CoventBridge Group is growing—and we’re looking for experienced investigators to join our elite surveillance team. In this role, you’ll conduct discreet, vehicle-based field investigations to help uncover insurance fraud and deliver trusted results to our clients. As a leader in the fraud investigation industry, CoventBridge offers the opportunity to work remotely with flexible scheduling, advanced tools, and the support of a nationwide team. Responsibilities/ Requirements Key Responsibilities: - Case Prep: Use social media and database tools to conduct initial research and gather intel on subjects. - Surveillance in the Field: Carry out discreet, mobile and stationary surveillance—track movements and capture high-quality video evidence. - Reporting: Write thorough, court-ready reports that clearly document key activities and findings. - Evidence Submission: Wrap up each day by uploading reports and video footage from your personal laptop. - Team Collaboration: Stay connected with your field supervisor for ongoing support, guidance, and mentorship. Essentials for this Role: - PI License: Must currently hold—or be eligible to obtain—Private Investigator license in New York. - Driver's License: Active driver's license that is not currently suspended or revoked. - Personal Vehicle: A well-maintained vehicle that is always reliable (preferably with tinted windows). Proof of auto insurance coverage is required. - Travel Expectations: While we aim to keep assignments within a reasonable drive of your residence, occasional further travel and overnight stays (covered by the company) may be required. - Technology: A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks. - Required Skills: Strong computer & internet proficiency. Excellent communication, verbal & writing skills. Possess or is willing to purchase covert camera, digital video camera with uploading capabilities, and laptop computer with Windows Operating System with access to Microsoft Word Additional Responsibilities: Duties and responsibilities include essential functions of positions assigned to this classification. Depending on assignment, the employee may perform a combination of some or all the following duties: - Conduct Fixed and Mobile Video Surveillance: Capture high-quality video footage of subjects to assist in case investigations. - Gather Evidence: Obtain videotaped documentation, photos, and audio recordings as part of thorough surveillance. - Background and Activity Checks: Perform courthouse research, background checks, and monitor subject activities to build robust case reports. - Investigative Reporting: Draft clear, concise, and detailed investigative reports summarizing findings and evidence. - Evidence Management: Upload all video, photographic, and audio evidence into the case management system in a timely and organized manner. - Drive Safely and Responsibly: Remain alert and practice safe driving while traveling to and from investigation sites. Working Conditions: - Most surveillance cases start at 6:00AM. End time can vary depending on activity. - Weekends/holidays are common workdays as claimants are more likely to be active. - This is an independent role often requiring long hours alone in your vehicle, regardless of weather conditions. - Must remain alert with no external distractions, ready to use videography equipment to document subjects. Benefits Compensation & Perks That Work For You: We believe great work deserves great rewards. Here’s what you can expect when you join our team: Competitive Pay: - Earn $26-$30 per hour, based on experience. On-the-Road Support: - Monthly vehicle allowance - Company fuel card - Company-issued cell phone - Monthly internet stipend - Travel & report writing compensation - Fast, hassle-free expense reimbursements (minimal out-of-pocket costs) Full Coverage Benefits: - Medical, dental, and vision insurance - Employer-paid life insurance, short-term & long-term disability Future-Focused Perks: - Company-matching 401(k) to help you build for the future - Paid time off to recharge and reset - Company-paid investigator licensing fees Career Growth: - Ongoing paid training and advancement opportunities to help you grow your skills and your career The salary range for this role is $26-$30 per hour. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs. About Us: CoventBridge Group is the global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide. CoventBridge Group is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace. CoventBridge Group is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com. CoventBridge (USA) Inc. New York License # 11000158134

Overview Medicare Medical Review RN (Medical Reviewer III) - REMOTE The Medicare Medical Review RN (Medical Reviewer III) will primarily be responsible for conducting clinical reviews of medical records during the course of fraud investigations or other program integrity initiatives such as requests for information or in support of proactive data analysis efforts. In addition, this position applies Medicare and Medicaid guidelines in making clinical determinations as to the appropriateness of payment coverage. In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse. This position will report directly to the Medical Review Supervisor and will work in our Grove City, OH office. If not local, remotely from a home office. Responsibilities/ Requirements Responsibilities: - Reviews information contained in Standard Claims Processing System files (e.g., claims history, provider files) to determine provider billing patterns and to detect potentially fraudulent or abusive billing practices or vulnerabilities in Medicare or Medicaid payment policies - Utilizes extensive knowledge of medical terminology, ICD-9-CM, ICD-10-CM HCPCS Level II and CPT coding along with analysis and processing of Medicare claims. Utilizes Medicare/Medicaid and Contractor guidelines for coverage determinations - Coordinates and compiles the written Investigative Summary Report to the PI Investigator upon completion of the records review - Incorporates leadership and communication skills to work with physicians and other health professionals as well as external regulatory agencies and law enforcement personnel - Provides training to UPIC staff on medical terminology, reading medical records, and policy interpretation - Provides expert witness testimony as required - Completes assignments in a manner that meets or exceeds the quality assurance goal of 98% accuracy - Maintains chain of custody on all documents and follows all confidentiality and security guidelines - Performs other duties as assigned by the Medical Review Supervisor that contribute to UPIC goals and objectives and comply with the Program Integrity Manual and Statement of Work guidelines and CMS directives and regulations Requirements: - 2 years minimum experience at a government contractor (ZPIC, UPIC, RAC, MAC, etc.) - 2 years minimum working knowledge of ICS 10-CM/CPT coding experience - 4 years minimum experience of working knowledge of Diagnosis Related Groups (DRG's), Prospective Payment Systems or Part B claims and Medicare coverage guidelines - Knowledge of, and the ability to correctly identify, Medicare and Medicaid coverage guidelines - Advance knowledge of medical terminology and experience in the analysis and processing of Medicare claims, utilization review/ quality assurance procedures, ICD 10-CM and CPT coding, Medicare coverage guidelines and payment methodologies (i.e., Correct Coding Initiative, DRG's, Prospective Payment Systems and Ambulatory Surgical center), NCPCP and other types of prescription drug claims - Ability to read Medicare claims, both paper and electronic, and a basic knowledge of the Medicare claims systems is required - Should possess excellent oral and written communication skills with an ability to write professional summary reports - Knowledge of and ability to use Microsoft Word, Excel, and Internet applications - Able to efficiently organize and manage workload and assignments - Must have and maintain a valid driver' license for the associate's state of residence as onsite audits are part of the role as a nurse reviewer Educational/Experience Qualifications: - Graduate from an accredited school of nursing and have an active license as a Registered Nurse (RN) required - Preference given to BSN or higher prepared nurses with recent medical review claims experience in Medicare or Medicaid reviews Benefits - Medical, Dental, Vision plans - Life, LTD and STD paid by the employer - 401(k) with company match up to 4% - Paid Time Off and company paid holidays - Tuition assistance after 1 year of service The salary range for this role is $65,000 to $75,000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs. Pursuant to the respective Fair Chance Ordinances of both Los Angeles and San Francisco, we will consider for employment qualified applicants with arrest and conviction records. About Us: CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide. CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace. CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com.