- 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
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Sr. Fraud Investigator SIU (Special Investigations Unit) assists in the implementation and daily operation of the organization's Compliance ... requirements of federal and state laws and regulations. The SIU Investigator will be responsible for identification, investigation and prevention of healthcare… more
- EFI Global (San Antonio, TX)
- …greater Houston TX area.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, large ... fire loss, and multiple claims .** **Ensures that assigned cases are investigated and reported...and ethical manner.** **May provide investigative guidance to Fire Investigator team members.** **Education & Licensing** **Bachelor's degree from… more
- Elevance Health (Grand Prairie, TX)
- **Clinical Fraud Investigator II** **Location: This position will work in a hybrid model (remote and office). The ideal candidate must live within 50 miles of our ... the requisition.** **Work schedule: M-F normal business hours** The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that may… more
- Elevance Health (Grand Prairie, TX)
- **Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within ... **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
- 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
- Allied Universal (Fort Worth, 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
- The Robison Group (Austin, TX)
- …such as auto and property theft, fire damages, auto accidents, commercial claims , finding missing persons, courthouse searches, and other investigative tasks. This ... for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible team of investigators and industry… more
- Centene Corporation (Austin, TX)
- …appropriateness and accuracy of diagnosis and procedure codes supporting such claims , coordinate medical necessity and appropriate level of care determinations with ... Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. Coordinate with internal and external resources in determining the appropriateness of codes found in administrative, medical, claim and… more