- 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, fire… 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...complex data to identify potential fraud schemes, and directs investigations to resolve issues effectively. This is a hybrid… more
- State of Massachusetts (Boston, MA)
- …highly organized, mission-driven individual to fill the role of Area Program Manager (APM) for the Special Investigations Unit ( SIU ). The Special ... The Area Program Manager is a member of the SIU senior management team, is involved with all aspects...of Children & Families* **Title:** *Area Program Manager - Special Investigations Unit * **Location:** *Massachusetts-Boston-600… 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 ... project and administrative support to the SIU team. This role works independently and proactively to...securely stored.** + Serves as the guardian of the Consolidation/ Special Adjudication Unit (SAU) work with outside… more
- Capital One (Richmond, VA)
- …3 (12073), United States of America, Richmond, Virginia AML Sr. Investigator I - Special Investigations Unit **Anti-Money Laundering Sr. Investigator I - ... Complex Investigations Unit , Special Investigations Unit...- Self-manage a queue of alerts, cases, and closing investigations -Helps maintain operations of a SIU … more
- City of New York (New York, NY)
- …New York City Department of Correction seeks to recruit a Director to oversee the Special Investigations Unit 's ( SIU ) Intelligence Team. Under the direct ... management level position will be responsible for conducting all investigations into allegations of misconduct and special ...role and responsibilities of the Assistant Commissioner of the Special Investigation Unit in his/her absence -… 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
- Allied Universal (Minneapolis, MN)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… 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 (Houston, TX)
- …+ 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)
- …an insurance Investigator is required. Must have background in handling multi-lines investigations and some SIU experience. Must have reliable transportation, ... Seeking a full-time experienced SIU /Insurance investigator. A minimum of 3 years' experience...should demonstrate proficiency in the following areas: + Multi-lines investigations + Writing accurate and detailed reports + Strong… more
- Command Investigations (San Diego, CA)
- SIU INVESTIGATOR A minimum of 5 years' SIU experience is required. Must have experience in Commercial and P&C investigations . * Candidates who do not have ... 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
- Command Investigations (Ventura County, CA)
- Experienced SIU Investigator A minimum of 5 years' SIU experience is required. Must have background in handling P&C investigations . Candidates who do not ... 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 … 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 resolving instances of healthcare fraud and abuse by medical… more
- Travelers Insurance Company (Franklin, TN)
- …expertise to identify potential risks and combat fraudulent practices. As an SIU Investigator, you will analyze, summarize and prioritize information to uncover ... all lines of business. The investigator will conduct thorough and comprehensive investigations in a dynamic, fast paced environment. This position may include a… 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
- 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 (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
- 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 ... concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation. **Minimum Requirments:** + Requires an AA/AS and minimum of 1 year related medical coding/auditing experience; or any combination of… more
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