- The Robison Group (Brooklyn, NY)
- …writing, reading and speaking Spanish. 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, fire… more
- LA Care Health Plan (Los Angeles, CA)
- …Fraud, Waste and Abuse (FWA) is responsible for directing LA Care Health Plan's enterprise special investigations unit ( SIU ) and FWA program. The ... and motivating direct reports. Duties Leadership and Program Oversight: Lead LA Care's Special Investigations Unit ( SIU ) in overseeing the internal and… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The AVP Special Investigations Unit ( SIU ) is responsible for overseeing and managing fraud, waste, and abuse (FWA) detection, ... assets and reduce healthcare costs. This requires demonstrating vision in positioning the SIU with the right skill sets, cutting edge analytics tools, and robust… more
- Allied Universal (South Farmingdale, NY)
- …best, explore a career with us and make a difference. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… more
- UPMC (Pittsburgh, PA)
- …audits and investigations highly preferred. Under the direction of the manager, the Special Investigations Unit ( SIU ) Investigator is responsible for ... UPMC Health Plan has an exciting opportunity for a SIU Investigator! This is a remote, full-time role working daylight hours Monday through Friday. Experience as a… more
- USAA (Atlanta, GA)
- …we treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). ... **This is a "Desk" position.** **Besides the normal SIU Investigator responsibilities, you will also** **perform triage duties...by our predicative fraud tool to determine if an SIU investigation is warranted** **.** Within defined guidelines and… more
- Kemper (San Bernardino, CA)
- …and conducting and/or directing Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department of Insurance ... SIU Manager and provide work direction to other Special Investigators on a temporary basis. A laptop computer,...management. + Responsible for communicating critical situations to the Special Investigation Unit and field managers. +… more
- Command Investigations (Chicago, IL)
- Seeking an experienced SIU /Insurance investigator to cover Chicago, IL and its surrounding areas. Candidates must reside within 60 miles of Chicago. A minimum of 5 ... years' SIU experience is required. Must have background in handling...experience is required. Must have background in handling multi-lines investigations with personal lines highly desired. Must have reliable… more
- Kemper (Doral, FL)
- …investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit . Our Special Investigator will function as ... and conducting and/or directing Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department of Insurance… more
- Command Investigations (Orlando, FL)
- …an insurance Investigator is required. Must have background in handling multi-lines investigations and some SIU experience. Must have reliable transportation, ... Seeking a full-time experienced SIU /Insurance investigator. A minimum of 3 years' experience...should demonstrate proficiency in the following areas: + Multi-lines investigations + Writing accurate and detailed reports + Strong… more
- Philadelphia Insurance Companies (Ewing, NJ)
- …investigator reports for thoroughness and accuracy. Review and evaluation of completed SIU investigations for referral to state authorities, law enforcement ... and evaluation of claims and applications referred to the SIU for possible fraud. Conduct database investigations ,...the SIU for possible fraud. Conduct database investigations , including use of CLEAR, ISO and various search… more
- Command Investigations (Ventura County, CA)
- Experienced SIU Investigator A minimum of 5 years' SIU experience is required. Must have background in handling P&C investigations . Candidates who do not ... staff. This is a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the following areas: + P&C … more
- Command Investigations (San Diego, CA)
- SIU INVESTIGATOR A minimum of 5 years' SIU experience is required. Must have experience in Commercial and P&C investigations . * Candidates who do not have ... assignments. This is a W-2 role; subcontractors will not be considered. The SIU Investigator should demonstrate proficiency in the following areas: + P&C … more
- Magellan Health Services (Boise, ID)
- …for comprehensive management and ownership of fraud, waste and abuse investigations including development and presentation of investigative results. This individual ... recommends cost containment projects with an emphasis on fraud prevention. + INVESTIGATIONS + Prioritize, triage and manage workload to meet internal performance… more
- Command Investigations (Baltimore, MD)
- …Claims/ SIU and/or Workers' Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and Industrial/workplace accidents. ... Investigators and staff. Must have a background in handling multi-lines investigations with personal lines highly desired. Must have reliable transportation, along… more
- Centene Corporation (Tallahassee, FL)
- …Florida. **Position Purpose:** Oversee a full range of waste, abuse and fraud investigations , audits and medical code editing scenarios. Ensure all audits adhere to ... and abuse guidelines. + Oversee the activities of the SIU for accurate and timely operational reviews and final...or equivalent + 7+ years of related compliance and/or special investigation experience in managed care or CMS Pay… more
- Centene Corporation (Frankfort, KY)
- …Position acts as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud, Waste and Abuse of Medicaid services within Kentucky. Provides ... + Manage and coordinate cases being investigated by the SIU + Maintain all vendor cases + Assist with...Maintain all vendor cases + Assist with conducting complex investigations , including on-site investigations , review, complete and… more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** SIU Government Programs - Medi **Equal Employment Opportunity** CareFirst ... BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national… more
- Sedgwick (Buffalo, NY)
- …Fortune Best Workplaces in Financial Services & Insurance Manager, Client Services | SIU **PRIMARY PURPOSE** : To manage accounts of multiple client service programs ... or single large national program; to maintain client, client broker and key vendor relationships; and to manage program procedures and processes that impact customer satisfaction ensuring consistency in process within the account as well as client retention.… more
- CVS Health (Columbus, OH)
- …**Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely ... in identifying resources and best course of action on investigations + Serves as back up to the manager...years working on health care fraud, waste, and abuse investigations and audits; **Anticipated Weekly Hours** 40 **Time Type**… more