- Humana (Tallahassee, FL)
- …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 (FL)
- **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...assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background… 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
- Kemper (Lake Mary, FL)
- …claims referred to and accepted for investigation by the Special Investigative Unit . Our Special Investigator will function as an investigator ... 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
- Molina Healthcare (Jacksonville, FL)
- **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
- 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
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... clinic settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location + Thorough knowledge of PC based… more
- Command Investigations (Tampa, FL)
- …on all assignments. This is a W-2 role; subcontractors will not be considered. The SIU Investigator should demonstrate proficiency in the following areas: + P&C ... 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… more
- Elevance Health (FL)
- …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
- Allied Universal (Coconut Creek, FL)
- …As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our diverse and inclusive team is ... and exclusive perks. Allied Universal(R) is hiring a Surveillance Investigator . Surveillance Investigators perform discreet mobile and stationary surveillance of… more
- Allied Universal (Jacksonville, FL)
- …As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our diverse and inclusive team is ... and exclusive perks. Allied Universal(R) is hiring a Surveillance Investigator . Surveillance Investigators perform discreet mobile and stationary surveillance of… more
- Command Investigations (FL)
- Command Investigations LLC is a dynamic and forward-thinking investigative company that has been at the forefront of the industry since its establishment in ... as a leader in the investigation industry. At Command Investigations , we take pride in our proven track record...with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required, as… more
- Command Investigations (Pensacola, FL)
- …lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals ... Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, Auto, or… more