- 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 (Santa Cruz, CA)
- …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
- Command Investigations (GA)
- …hire. Visit our website and find out why at www.GoCommand.com . The Claims /Surveillance Investigator should demonstrate proficiency in the following areas: + ... Command Investigations LLC is a dynamic and forward-thinking investigative...with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required, as… more
- The Robison Group (St. Louis, MO)
- …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
- 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
- Allied Universal (Fairfax, VA)
- … Unit ( SIU ) Investigator . Special Investigations Unit ( SIU ) Specialists investigate claims with red flags that suggest fraudulent behavior ... five (5) 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
- Humana (Columbus, OH)
- …enforcement authorities to coordinate investigations and supervises the activities of the Special Investigations Unit ( SIU ) to ensure accurate and ... put health first** The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The...field or equivalent. 7+ years of related compliance and/or special investigation experience in managed care or CMS. +… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw… more
- Kemper (Miami, FL)
- …our stakeholders that delivers on our promises._ **Position Summary:** The SIU Investigator will conduct field and desk investigations of insurance claims ... accepted for investigation by the Special Investigative Unit . Our Special Investigator will...Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department… more
- CVS Health (Tallahassee, FL)
- …an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ). In this role, you will manage complex ... Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Researches and prepares… more
- NJM Insurance (Parsippany, NJ)
- NJM's SIU is seeking a Special Investigator to join our team. The candidate will primarily be responsible for investigative duties surrounding claims and ... policies of all lines of business referred to the SIU to determine if there is a reasonable suspicion...experience strongly preferred. + Subject matter expertise in insurance investigations is preferred. + Experience in working with the… more
- Molina Healthcare (Meridian, ID)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to make… more
- Molina Healthcare (KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to make… more
- Molina Healthcare (Columbus, OH)
- **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
- Travelers Insurance Company (Alpharetta, GA)
- …and expertise to identify potential risks and combat fraudulent practices. As an SIU Investigator , you will analyze, summarize and prioritize information to ... uncover potentially fraudulent activity. The investigator , supporting a Claim Center, will investigate ...suspicious in nature within all lines of business. The investigator will conduct thorough and comprehensive investigations … more
- Elevance Health (Washington, DC)
- …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
- Kemper (Henderson, NV)
- …experience to our stakeholders that delivers on our promises._ **POSITION SUMMARY** : The SIU Desk Investigator I is responsible for the investigation of simple ... claims that may contain elements of fraud or ...management. + Responsible for communicating critical situations to the Special Investigation Unit and field managers. +… more
- American Family Insurance - Corporate (Sacramento, CA)
- …multi-line claims , develop meaningful industry social network and assist special investigations leadership in promoting fraud awareness and detection with ... agents and customers. You will report to a Senior Special Investigations Manager. In this primarily home-based...auto clams + 2+ years of experience in property claims We encourage you to apply even if you… more
- CareFirst (Baltimore, 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