- USAA (San Antonio, TX)
- …of 10 consecutive business days each calendar year. As a dedicated with **Director, Special Investigations Unit ( SIU ),** you will be responsible ... and fraud investigation programs and management of the Life Special Investigation Unit ( SIU ) staff....Experience to include broad understanding of procedures related to SIU investigations . + Knowledge and experience in… more
- The Robison Group (Tampa, FL)
- …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
- 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...eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long… more
- ICW Group (Sacramento, CA)
- …opportunities to contribute, develop, and belong. **PURPOSE OF THE JOB** The purpose of the Special Investigations Unit ( SIU ) Coordinator is to provide ... The SIU Coordinator will regularly communicate with Department of Insurance (DOI) personnel, District Attorney Offices, Private Investigations (PI) partners,… more
- Allied Universal (Rochester, NY)
- …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
- Humana (Indianapolis, IN)
- …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 ... to encourage sensible and culturally-competent business standards + Oversee internal investigations of FWA compliance issues + Work with the Contract Compliance… more
- USAA (Colorado Springs, CO)
- …P&C experience to include Auto, Property and Underwriting + Current or prior SIU investigations experience working in diverse teams across multiple functions ... Come be a part of what makes us so special ! **The Opportunity** As a dedicated SIU investigator,...within SIU + SIU , Fraud Investigations , Military… more
- USAA (Atlanta, GA)
- …+ Leads high exposure, high profile and critical work assignments, and special investigations involving sophisticated niche fraud referrals, (examples: organized ... Come be a part of what makes us so special ! **The Opportunity** As a dedicated SIU ...members from potential fraudulent claims by investigating complex fraud investigations with significant financial impact to USAA. This may… 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
- Command Investigations (Tampa, FL)
- 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
- NJM Insurance (Trenton, NJ)
- NJM's SIU department in West Trenton, NJ is seeking a Summer Intern for 2025. Job Responsibilities: + Triaging and analyzing scorecards and outputs from predictive ... that can be consumed by non-technical staff. + Share analytical findings with SIU Supervisory staff. + Attend virtual industry meetings to broaden exposure to 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
- Travelers Insurance Company (Franklin, TN)
- …into actionable investigative strategies including the identification of complex case investigations . + Conducts insurance investigations including ... officials, law enforcement officers and others to obtain assistance in conducting investigations . + Identifies cases for potential insurance fraud prosecution… more
- Molina Healthcare (IA)
- …(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
- 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
- Elevance Health (Woburn, MA)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will...clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims… more
- Elevance Health (Manchester, NH)
- …and billing issues, trends, and changes in laws/regulations. + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual ... and long term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name a few. Elevance… more
- Centene Corporation (Sacramento, CA)
- …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
- CareFirst (Columbia, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Investigator, Sr. is to assist in the reduction and recuperation ... projects as assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education Level:** Bachelor's Degree… 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