- The Robison Group (Memphis, TN)
- …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
- USAA (San Antonio, TX)
- …special ! **The Opportunity** As a dedicated **Director, Special Investigations Unit for Property & Casualty Insurance ** , you will be responsible for ... fraud control objectives, as well as compliance with state insurance fraud-related laws and regulations. We offer a flexible... policies and broad understanding of procedures related to SIU investigations . . Capability to analyze data,… more
- Allied Universal (Baltimore, MD)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …15 miles north of Seattle, Washington.** **What you'll do:** + Lead Premera's Special Investigations Unit in driving the development, implementation, and ... blog: https://healthsource.premera.com . As a **Senior Manager of the Special Investigation Unit ( SIU )** ,...to prepare case files. + In-depth knowledge of the insurance industry, Special Investigation Unit … more
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Sr. Fraud Investigator SIU ( Special Investigations Unit ) assists in the implementation and daily operation of the organization's ... the strictest form of confidentiality is applied to all audits and investigations conducted **Job Title: Sr. Fraud Investigator ( SIU )** **Location: Pearland… more
- CareFirst (Baltimore, MD)
- …programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Special Investigations Unit **Equal Employment Opportunity** ... + Serves as a technical resource / coding subject matter expert for SIU related issues. Conducts complex business and operational analyses to assure payments are… more
- Command Investigations (Orlando, FL)
- Seeking a full-time experienced SIU / Insurance investigator. A minimum of 3 years' experience as an insurance Investigator is required. Must have background ... in handling multi-lines investigations and some SIU experience. Must have...a W-2 role; subcontractors will not be considered. The SIU / Insurance Investigator should demonstrate proficiency in the… more
- USAA (Toledo, OH)
- …treatment, and medical terminology. **What sets you apart:** + Current or prior SIU investigations experience working in diverse teams across multiple functions ... by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. **The… more
- Command Investigations (Ventura County, CA)
- …and 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 ... Experienced SIU Investigator A minimum of 5 years' ...experience is required. Must have background in handling P&C investigations . Candidates who do not have property (non-auto) experience… more
- State of Michigan (MI)
- Conservation Officer 12 ( SIU CPL DET) Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4657398) Apply Conservation Officer 12 ( SIU CPL DET) ... Resources Opening Date 09/13/2024 Closing Date 9/29/2024 11:59 PM Eastern Bargaining Unit MICHIGAN STATE EMPLOYEES ASSOCIATION (MSEA) + Description + Benefits +… more
- Molina Healthcare (Owensboro, 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
- Command Investigations (San Jose, CA)
- A minimum of 5 years' SIU experience is required. Must have experience in P&C investigations . * Candidates who do not have property (non-auto) experience will ... 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
- Sedgwick (Naperville, IL)
- …ensures investigations are completed according to service expectations and SIU best practices. + Maintains technical competency and adherence with all applicable ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer SIU Research Investigator **PRIMARY PURPOSE** **:** To perform claims investigations… more
- Centene Corporation (New York, NY)
- …**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...field or equivalent. 7+ years of related compliance and/or special investigation experience in managed care or CMS. **Please… more
- Centene Corporation (Olympia, WA)
- …and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud ... and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document...referral to Federal and State agencies + Complete various special projects and audits **Education/Experience:** Bachelor's Degree in Business,… more
- Citigroup (Florence, KY)
- …drive the SAR management process from Start to Finish. + Conduct investigations of potentially suspicious and/or high-risk clients and communicate with other ... including: medical, dental & vision coverage; 401(k); life, accident, and disability insurance ; and wellness programs. Citi also offers paid time off packages,… more
- Citigroup (Florence, KY)
- …including: medical, dental & vision coverage; 401(k); life, accident, and disability insurance ; and wellness programs. Citi also offers paid time off packages, ... including planned time off (vacation), unplanned time off (sick leave), and paid holidays. For additional information regarding Citi employee benefits, please visit citibenefits.com. Available offerings may vary by jurisdiction, job level, and date of hire.… more
- Providence (CA)
- …will:** + Support timely completion of compliance related audits and investigations of the Special Investigations Unit ( SIU ) at the Health Plan + ... multiple cases and audits simultaneously + May assist Senior Investigator or SIU Director in developing, implementing and performing compliance related auditing and… more
- Centene Corporation (Austin, TX)
- …potential FWA, including the coordination of internal investigations with the Special Investigations Unit and the development of appropriate corrective ... development and implementation of Corrective Action Plans + Coordinating potential fraud investigations and referrals from and with the SIU , where applicable,… more
- Travelers Insurance Company (Lake Oswego, OR)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions...essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state… more