• Manager, Fraud and Waste * Special

    Humana (Lansing, MI)
    …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
    Humana (12/19/24)
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  • Investigator , SIU

    Molina Healthcare (MI)
    **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
    Molina Healthcare (12/04/24)
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  • Investigator , Coding SIU (Remote)

    Molina Healthcare (Ann Arbor, MI)
    **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
    Molina Healthcare (12/15/24)
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  • Nurse and CPC - Clinical Fraud Investigator

    Elevance Health (Dearborn, MI)
    …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
    Elevance Health (10/01/24)
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  • Surveillance Investigator

    Allied Universal (Lansing, MI)
    …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 (12/20/24)
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