- WMCHealth (Valhalla, NY)
- Claims Investigator Company : NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Professional/Non-Clinical Department: Risk Management- WMC ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/26645) Internal Applicant link Job Details: Job Summary: The Claims Investigator is responsible for the management… more
- Allied Universal (Billings, MT)
- …programs, and exclusive perks. Allied Universal(R) is hiring a Surveillance / Claims Investigator . Surveillance / Claims Investigators validate the ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Allied Universal (Los Angeles, CA)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Claims / SIU Investigator . Claims / SIU Specialists investigate ... that suggest fraudulent behavior In relation to an Insurance claim . The Claims / SIU Specialist must...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...database information found in systems such as Unitrac, insurance company websites, Lexis Nexis, ISO, and other automobile databases… more
- State of Indiana (Indianapolis, IN)
- Claims Investigator Date Posted: Nov 13, 2024 Requisition ID: 452302 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with the ... to thrive in a changing economy. Role Overview: A Claims Investigator ("CI") is part of the...and correct system error list related to wage reporting, claim computation, and payment of benefits. The job description… more
- CareFirst (Columbia, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit (SIU) Investigator , Sr. is to assist in the reduction and recuperation of losses ... of financial business records, provider and subscriber medical data, claims , systems? reports, medical records, analysis of contract documents, provider/subscriber… more
- Allied Universal (Sarasota, FL)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU… more
- Allied Universal (Roanoke, VA)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU… more
- Elevance Health (Mendota Heights, MN)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator II** **Supporting the Payment Integrity line of business** _Location:...of proprietary data and claim systems for review of facility, professional… more
- Elevance Health (Houston, TX)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator II** **Supporting the Payment Integrity line of business** _Location:...of proprietary data and claim systems for review of facility, professional… more
- Kaleida Health (Buffalo, NY)
- …thorough investigations into employee allegations or misconduct or violations of the company 's policies including but not limited to claims of discrimination, ... Vision and Values of Kaleida Health. The Sr. HR Investigator will be responsible for reviewing complaints and planning,...Labor & Employment Counsel to investigate third party agency claims such as but not limited to EEOC, NYS… more
- State of Connecticut, Department of Administrative Services (Norwich, CT)
- Social Services Lead Investigator - Child Support Hybrid Recruitment # 241113-7324SH-001 Location Norwich, CT Date Opened 11/15/2024 10:30:00 AM Salary $70,026 - ... to join our team as a Social Services Lead Investigator - Child Support! The State of Connecticut (https://portal.ct.gov/)...+ The opportunity to work for a Forbes top company : 'Forbes' State of Connecticut Ranked one of the… more
- Manulife (Boston, MA)
- …with expertise assessing and investigating suspicious activity / behavior during the claim process. The candidate will be a thought leader identifying and preventing ... proactively prevent fraud, waste & abuse within the LTC claims process. You will partner with all squads to...savings associated with fraud, waste & abuse. The LTC Investigator will conduct desktop investigations of high complexity related… more
- The Cigna Group (Bloomfield, CT)
- **POSITION SUMMARY** Join our Special Investigations Unit as a Fraud Investigator , supporting our US Commercial Healthcare Business, responsible for conducting and ... supporting audits and investigations of potentially fraudulent claim activity by providers. You will bring complex investigative and analytic skills that include… more
- Elevance Health (Los Angeles, CA)
- **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... **Hybrid Workplace Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that may pose… more
- Humana (Indianapolis, IN)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the program integrity … more
- The Robison Group (Albany, NY)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... Candidates must be willing and able to obtain a New York Private Investigator license. + Self-motivated, determined, and intuitive. + Strong initiative and work… more
- Trane Technologies (Davidson, NC)
- …boldly challenging what's possible for a sustainable world. The Employee Relations Investigator will play a pivotal role in managing and resolving complex employee ... the highest standards of integrity and professionalism. The Employee Relations Investigator will also partner closely with internal stakeholders, such as Legal… more
- Henry Ford Health System (Detroit, MI)
- …Under the direction of the Compliance Audit Manager, the Principal Compliance Investigator will oversee compliance auditing and monitoring to assess and identify ... and State regulatory and contractual requirements. The Principal Compliance Investigator is responsible for conducting compliance audits, reporting results,… more
- Manulife (FL)
- **Responsibilities:** + . Successfully completes high-quality, sophisticated long term care claims investigations + . Independently develops and drives a detailed ... / prioritize concurrent assignments + . Adheres to departmental, company and regulatory timelines, policies, and requirements + ....and trains more junior investigators on long term care claim cases and processes + . Ability to travel… more