• Claims Investigator

    Allied Solutions (Plano, TX)
    …and exceed all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim… more
    Allied Solutions (01/13/25)
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  • Research Investigator

    Baylor Scott & White Health (Dallas, TX)
    **Research Investigator (PhD)** **Dallas, TX** **M-F 8a- 5p** **GENERAL DESCRIPTION:** * Baylor Scott and White North Texas Region is looking for an early career PhD ... PACER Center - Patient and Community Engaged Research Center. * The Research Investigator independently leads and manages research efforts at Baylor Scott and White… more
    Baylor Scott & White Health (11/20/24)
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  • Investigator , SIU RN

    Molina Healthcare (Dallas, TX)
    **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to make medical determinations… more
    Molina Healthcare (01/21/25)
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  • Fire Investigator

    EFI Global (Dallas, TX)
    …and RESPONSIBILITIES** **Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of ... the insurance industry and law enforcement/fire service personnel.** **Investigates losses/ claims with illegal, fraudulent or subrogation aspects in accordance with… more
    EFI Global (01/22/25)
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  • Investigator II

    Elevance Health (Grand Prairie, TX)
    ** Investigator II** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of Grand Prairie, Texas. ... The ** INVESTIGATOR II** is responsible for the identification, investigation and...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
    Elevance Health (01/17/25)
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  • Nurse and CPC - Clinical Fraud Investigator

    Elevance Health (Grand Prairie, TX)
    **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... **Hybrid Workplace Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that may pose… more
    Elevance Health (12/31/24)
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  • Investigator , Coding SIU (Remote)

    Molina Healthcare (Dallas, TX)
    **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims more
    Molina Healthcare (12/15/24)
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  • Surveillance Investigator

    Allied Universal (Dallas, TX)
    Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... and exclusive perks. Allied Universal(R) is hiring a Surveillance Investigator . Surveillance Investigators perform discreet mobile and stationary surveillance of… more
    Allied Universal (01/15/25)
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