- CVS Health (Trenton, NJ)
- …an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ). In this role, you will manage complex ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.… more
- The Hartford (GA)
- …the future. We are seeking a talented Special Investigator to join our Special Investigations Unit ( SIU ). This position will be based out of ... SIU Investigator - CF08BE We're determined...will require 100% travel within the assigned territory. The Special Investigator for this opportunity will be… more
- The Robison Group (Brooklyn, NY)
- …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 (Fredericksburg, VA)
- …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
- CVS Health (Raleigh, NC)
- …- Exhibits behaviors outlined in Employee Competencies - Exhibits behaviors outlined in SIU Investigator Competencies - May include travel to testify in court ... flexible to work EDT hours (8:00 am - 5 pm EDT) Conducts investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare… more
- Kemper (Sacramento, CA)
- …and/or directing Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department of Insurance Fraud ... that delivers on our promises._ **POSITION SUMMARY** : The SIU Investigator III is responsible for the...management. + Responsible for communicating critical situations to the Special Investigation Unit and field managers. +… more
- Kemper (Pomona, CA)
- …insurance claims referred to and accepted for investigation by the Special Investigative Unit . Our Special Investigator will function as a remote ... Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department...agencies as required by law and management. Keeps the Special Investigation Unit and field managers advised… more
- Kemper (Miami, FL)
- …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
- AmeriHealth Caritas (Columbia, SC)
- …administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of ... related to Special Investigation Units and fraud, waste and abuse investigations . + Conducts investigations of potential; fraud, waste and/or abuse with… more
- Capital One (Mclean, VA)
- Anti-Money Laundering Subject Matter Expert (SME) - Special Investigations Unit ( SIU ) The Special Investigations Unit in the AML Department ... (SME) will work closely with key stakeholders in the SIU and outside of the SIU when...+ Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in… more
- CVS Health (Frankfort, KY)
- …are seeking an experienced Senior Healthcare Fraud Investigator (Pharmacy) to join our Special Investigations Unit . In this role, you will manage complex ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conducts high level, complex investigations of known or suspected acts of Pharmacy Fraud, Waste and Abuse. +… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The AVP Special Investigations Unit ( SIU ) is responsible for overseeing and managing fraud, waste, and abuse (FWA) detection, ... assets and reduce healthcare costs. This requires demonstrating vision in positioning the SIU with the right skill sets, cutting edge analytics tools, and robust… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and...Services, Member Services, Claims) to gather documentation pertinent to investigations . * Detect potential health care fraud, waste, and… more
- Molina Healthcare (AZ)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and...Services, Member Services, Claims) to gather documentation pertinent to investigations . * Detect potential health care fraud, waste, and… more
- Insight Global (San Antonio, TX)
- …well as monitor appropriate loss and expense claims reserves. As a Mid-Level Life SIU Investigator for Medicare Supplement Fraud, Waste, and Abuse you will ... San Antonio, TX area is looking for a remote SIU Life and Health investigator . As a...support the Life Special Investigations team that is responsible for… more
- City of New York (New York, NY)
- …The New York City Department of Correction seeks to recruit Investigators for the Special Investigation Unit ( SIU )- PREA Team. The Prison Rape Elimination ... September 4, 2003. Under the direction of a Supervisor Investigator for the SIU PREA and with...engaged in the performance of confidential, highly complex, and/or special investigations involving surveillance, interrogation of subjects… 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
- Elevance Health (Atlanta, GA)
- …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 &...clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims… 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 ... by law and management. + Responsible for communicating critical situations to the Special Investigation Unit and field managers. + Develops and maintains… more