- Insight Global (San Antonio, TX)
- Job Description . An employer in the San Antonio, TX area is looking for a remote SIU Life and Health investigator . As a dedicated SIU Life & ... appropriate loss and expense claims reserves. As a Mid-Level Life SIU Investigator for Medicare...Supplement Fraud, Waste, and Abuse you will support the Life Special Investigations team that… more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, ... 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
- Humana (Columbus, OH)
- …enforcement authorities to coordinate investigations and supervises the activities of the Special Investigations Unit ( SIU ) to ensure accurate and ... 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
- CVS Health (Tallahassee, FL)
- Bring your heart to CVS Health . Every one of us at CVS Health... Investigator to join our Special Investigations Unit (Aetna SIU ). In this ... purpose: Bringing our heart to every moment of your health . This purpose guides our commitment to deliver enhanced...abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud,… 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
- CVS Health (Frankfort, KY)
- Bring your heart to CVS Health . Every one of us at CVS ...Healthcare Fraud Investigator (Pharmacy) to join our Special Investigations Unit . In this ... purpose: Bringing our heart to every moment of your health . This purpose guides our commitment to deliver enhanced...abuse (FWA). **Key Responsibilities** + Conducts high level, complex investigations of known or suspected acts of Pharmacy Fraud,… more
- Elevance Health (Mason, OH)
- …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 &...live within 50 miles of one of our Elevance Health PulsePoint locations. **Hybrid Workplace Strategy:** 1-2 days in… 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 ... claims deemed suspicious in nature within all lines of business. The investigator will conduct thorough and comprehensive investigations in a dynamic,… 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
- American Family Insurance - Corporate (Sacramento, CA)
- …involving multi-line claims, develop meaningful industry social network and assist special investigations leadership in promoting fraud awareness and detection ... agents and customers. You will report to a Senior Special Investigations Manager. In this primarily home-based...can be used in many different ways, and your life and professional experience may be relevant beyond what… more
- Fallon Health (Worcester, MA)
- **Overview** **About us:** Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in ... 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans… more
- CVS Health (Hartford, CT)
- …- Exhibits behaviors outlined in Employee Competencies - Exhibits behaviors outlined in SIU Investigator Competencies - May include travel to testify in court ... Bring your heart to CVS Health . Every one of us at CVS ...EDT hours (8:00 am - 5 pm EDT) Conducts investigations to effectively pursue the prevention, detection, investigation and… more