- Allied Universal (Beckley, WV)
- … training/orientation course + Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims ... Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations ,...and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance… more
- USAA (Chesapeake, VA)
- …+ Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit ( SIU ) referrals, when appropriate. Determines ... Come be a part of what makes us so special ! It is all about learning and growing. Our...to investigate, evaluate, negotiate, and settles low complexity property insurance claims . You will confirm/analyze coverage, recognize… more
- The Robison Group (Kansas City, MO)
- …searches, and other investigative tasks. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft,… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. Kentucky Resident is preferred The SIU Investigator conducts complex investigations to effectively pursue the ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- CVS Health (Columbus, OH)
- …+ Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and prepares ... personal, convenient and affordable. **Position Summary** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and… more
- CVS Health (Columbus, OH)
- …Summary:** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely ... fraud schemes - Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business -...in identifying resources and best course of action on investigations - Serves as back up to the Team… more
- Allied Universal (Dallas, TX)
- … Unit ( SIU ) Investigator. Special Investigations Unit ( SIU ) Specialists investigate claims with red flags that suggest fraudulent ... years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- ICW Group (Sacramento, CA)
- …opportunities to contribute, develop, and belong. **PURPOSE OF THE JOB** The purpose of the Special Investigations Unit ( SIU ) Coordinator is to provide ... The SIU Coordinator will regularly communicate with Department of Insurance (DOI) personnel, District Attorney Offices, Private Investigations (PI) partners,… more
- USAA (San Antonio, TX)
- …P&C experience to include Auto, Property and Underwriting + Current or prior SIU investigations experience working in diverse teams across multiple functions ... Come be a part of what makes us so special ! **The Opportunity** As a dedicated SIU ...potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance … more
- Travelers Insurance Company (Hartford, CT)
- …and 3rd party auto physical damage claims , including both personal and business insurance claims . The claim types will be basic to moderate physical damage ... as well as fire, theft, flood, lightning, diminished value claims and any claims that involve injuries....resolution and pursuit of alternative recovery sources (eg Subrogation, SIU , etc.). + Negotiates the claim with the customer… more
- Humana (Indianapolis, IN)
- …Program Integrity (OMPP PI) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in Ohio to increase ... to encourage sensible and culturally-competent business standards + Oversee internal investigations of FWA compliance issues + Work with the Contract Compliance… more
- Travelers Insurance Company (Downers Grove, IL)
- …3rd party auto physical damage claims , including both personal and business insurance claims . The claim types will be predominately basic and some moderate ... and some comprehensive; typically excludes fire, theft, flood, lightning, diminished value claims and any claims that involve injuries. The actual resolution… more
- USAA (Chicago, IL)
- …+ Leads high exposure, high profile and critical work assignments, and special investigations involving sophisticated niche fraud referrals, (examples: organized ... Come be a part of what makes us so special ! **The Opportunity** As a dedicated SIU ...help protect USAA and our members from potential fraudulent claims by investigating complex fraud investigations with… more
- NJM Insurance (Trenton, NJ)
- NJM is considering 2025 summer interns for our Special Investigations Unit , ( SIU ). Interns for the summer season will assist the SIU in anti-fraud ... and leveraging internal and external data sources to support SIU 's policy and claim investigations . The ...analyzing scorecards and outputs from predictive models for General Claims , Personal Lines, Personal Injury Protection (PIP) claims… more
- USAA (San Antonio, TX)
- …part of what makes us so special ! **The Opportunity** As a dedicated **Manager, Special Investigations Unit for Property & Casualty** , you will be ... fraud control objectives, as well as compliance with state insurance fraud-related laws and regulations. This is a **field-based**...SIU . + First and Third-Party auto and property claims investigations . + SIU or… more
- CVS Health (Hartford, CT)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** The Special Investigations Unit ( SIU ) is looking for an ... + A solid understanding of medical and pharmaceutical claim data, medical claims coding (CPT/ICD/NDC), Aetna clinical and payment policies, as well as core… more
- Axis (New York, NY)
- …internal and external business partners, insureds, claimants, agents, attorneys, other insurance companies, project team members, claims leadership, and vendors. ... Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding...candidates taking part in the selection process. AXIS Capital Claims Compliance Specialist, Claims Shared Services- Job… more
- NJM Insurance (Trenton, NJ)
- NJM's SIU department in West Trenton, NJ is seeking a Summer Intern for 2025. Job Responsibilities: + Triaging and analyzing scorecards and outputs from predictive ... models for General Claims , Personal Lines, Personal Injury Protection (PIP) ...consumed by non-technical staff. + Share analytical findings with SIU Supervisory staff. + Attend virtual industry meetings to… more
- Molina Healthcare (KY)
- …(surgical, hospital, clinic settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location + Thorough ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and...State & Federal laws and regulations pertaining to health insurance , investigations & legal processes (Commercial … more
- USAA (Houston, TX)
- …+ Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit ( SIU ) referrals, when appropriate. Determines ... and framework, investigates, evaluates, negotiates, and settles complex property insurance claims . You will confirm/analyze coverage, recognize liability… more