- Allied Universal (Billings, MT)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... exclusive perks. Allied Universal(R) is hiring a Surveillance / Claims Investigator . Surveillance / Claims ...of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims… more
- Command Investigations (San Diego, CA)
- CLAIMS INVESTIGATOR Seeking experienced investigator with multi-lines investigations to include AOE/COE, General Liability, and Auto, with Homeowner's ... highly desired. SIU experience is also highly desired, but not required....website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the… more
- Command Investigations (Fort Myers, FL)
- …for hire. Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, ... with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We...Auto, or Homeowners Investigations . + Writing accurate, detailed reports + Strong initiative,… more
- Allied Universal (Los Angeles, CA)
- …retirement plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Claims / SIU Investigator . Claims / SIU ... Los Angeles area to minimize travel** + **Will** **require** ** Claims and Surveillance investigations as needed to...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- The Robison Group (Tallahassee, FL)
- …opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU Investigator , you will be joining an incredible team ... 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
- CVS Health (Columbus, OH)
- …health care more personal, convenient and affordable. **Position Summary:** As a Senior Investigator you will conduct high level, complex investigations of known ... 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
- CVS Health (Wellesley, MA)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** The Special Investigations Unit is seeking a Sr. Manager to lead ... our new ASO investigations team. The Healthcare Fraud Senior Manager is responsible...investigation, or auditing + In-depth knowledge of healthcare systems, claims processing, and regulatory requirements related to healthcare fraud.… 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 ... 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… more
- USAA (Colorado Springs, CO)
- …a part of what makes us so special ! **The Opportunity** As a dedicated SIU investigator , you will protect USAA and our members from potential fraudulent ... School Diploma or General Equivalency Diploma. + 2 years claims adjusting experience, or P&C SIU /Fraud Investigation...include Auto, Property and Underwriting + Current or prior SIU investigations experience working in diverse teams… more
- USAA (Orlando, FL)
- …part of what makes us so special ! **The Opportunity** As a dedicated SIU field investigator , within defined guidelines and framework, you will help protect ... USAA and our members from potential fraudulent claims by investigating complex fraud investigations with...high exposure, high profile and critical work assignments, and special investigations involving sophisticated niche fraud referrals,… more
- Molina Healthcare (KY)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of...5+ years of experience working in a FWA / SIU or Fraud investigations role for New… more
- Elevance Health (Los Angeles, CA)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud &...investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines… more
- Centene Corporation (Sacramento, CA)
- …healthcare fraud 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...mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect… 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
- CareFirst (Columbia, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Investigator , Sr. is to assist in the reduction and ... projects as assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education Level:** Bachelor's Degree… more
- Allied Universal (Sarasota, FL)
- …Investigator 's license (apprenticeship) before applying** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
- The Robison Group (Albany, NY)
- Individuals selected for the position will be expected to perform investigations of workers compensation claims , liability investigations , multi-line ... We are looking for people who are enthusiastic about investigations , those who thrive in a diverse work environment,...willing and able to obtain a New York Private Investigator license. + Self-motivated, determined, and intuitive. + Strong… more
- Allied Universal (Roanoke, VA)
- …'s license** **required** **prior to applying** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
- Manulife (Boston, MA)
- …all squads to drive savings associated with fraud, waste & abuse. The LTC Investigator will conduct desktop investigations of high complexity related to LTC ... to drive fraud detection. **Individual Responsibilities:** + Successfully completes investigations with recommendations to internal Global Investigative & Forensic… more
- Fallon Health (Worcester, MA)
- …Internal Audit Manager, theAnalyze and interpret patient medical records pertaining to FWA investigations Compare to information submitted on the claims in order ... Interface with other clinicians including internal Medical Directors Provide training to SIU staff related to clinical topics as neededFWA Manager will oversees the… more