- 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
- Command Investigations (Laredo, TX)
- …for hire. 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 Homeowners Investigations. + Writing accurate, detailed reports + Strong initiative, integrity, and work ethic + Securing written/recorded statements + Accident scene investigations + Possession of a valid driver's license + Ability to prioritize and… more
- Allied Universal (Dallas, TX)
- …perks. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....+ Ability to be properly licensed as a Private Investigator as required by the state where work Is… more
- 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
- Insight Global (San Antonio, TX)
- …medical providers as appropriate, as well as monitor appropriate loss and expense claims reserves. As a Mid-Level Life SIU Investigator for Medicare Supplement ... is looking for a remote SIU Life and Health investigator . As a dedicated SIU Life & Health ...all life, health and waiver of life insurance premium claims to ensure claim validity and legal liability/risk management.… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
- Molina Healthcare (Austin, 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
- 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 (Houston, TX)
- ** Investigator II** **Supporting the Payment Integrity line of business** _Location:_ Alternate locations may be considered. This position will work in a hybrid ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator II** is responsible for the identification, investigation and development… more
- Molina Healthcare (Fort Worth, 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
- Allied Universal (Houston, 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 (Abilene, 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
- The Robison Group (Mcallen, TX)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... + Candidates must be willing and able to obtain a Texas Private Investigator license. + Self-motivated, determined, and intuitive. + Strong initiative and work… more
- CVS Health (Austin, TX)
- …more personal, convenient and affordable. **Position Summary** + As a Senior Investigator you will conduct high level, complex investigations of known or suspected ... or intricate healthcare fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares… more
- Merck (Austin, TX)
- …external medical and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs provide to ... interest to the company. The RMSD provides research support to our Investigator -Sponsored and Company-Sponsored Trials to enhance the understanding of the scientific… more
- Merck (Austin, TX)
- …and goals for approved, in-development, and active Company-sponsored trials and/or investigator -sponsored research studies. The RMSD serves as a role model for ... in the company's areas of interest Scientific exchange does not include promotional claims about any drug, vaccine, or biologic product. RMSDs have no sales… more
- Humana (Austin, TX)
- …investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated formal or informal people management + Excellent PC ... experience + CFE (Certified Fraud Examiner) or AHFI (Accredited Healthcare Fraud Investigator ) **Additional Information** + Benefits starting day 1 of employment +… more