- Humana (Santa Fe, NM)
- …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 (NM)
- **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 (Albuquerque, NM)
- **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 (Rio Rancho, NM)
- **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
- Allied Universal (Belen, NM)
- …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
- The Robison Group (Albuquerque, NM)
- Individuals selected for the position will be expected to perform investigations of workers compensation claims, liability investigations , multi-line insurance ... We are looking for people who are enthusiastic about investigations , those who thrive in a diverse work environment,...MUST hold a current and valid New Mexico Private Investigator license. + Self-motivated, determined, and intuitive. + Strong… more