• Surveillance / Claims Investigator

    Allied Universal (Billings, MT)
    …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for… more
    Allied Universal (09/27/24)
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  • Claims Investigator

    Command Investigations (Albuquerque, NM)
    CLAIMS INVESTIGATOR Seeking experienced investigator with both Worker's Compensation and General Liability Investigation experience. SIU experience is ... website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the...work ethic + Securing written/recorded statements + Accident scene investigations + Possession of a valid driver's license +… more
    Command Investigations (08/08/24)
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  • Claims Investigator

    Command Investigations (San Diego, CA)
    CLAIMS INVESTIGATOR Seeking experienced investigator with multi-lines investigations to include AOE/COE, General Liability, and Auto, with Homeowner's ... highly desired. SIU experience is also highly desired, but not required....website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the… more
    Command Investigations (08/08/24)
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  • Claims Investigator -Experienced

    Command Investigations (Los Angeles, CA)
    …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, ... with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We...Auto, or Homeowners Investigations . + Writing accurate, detailed reports + Strong initiative,… more
    Command Investigations (09/17/24)
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  • Claims / SIU Investigator

    Allied Universal (Durango, CO)
    …retirement plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Claims / SIU Investigator . Claims / SIU ... travel ** + **Remote work options!** + **Will** **require** ** Claims and Surveillance investigations as needed to...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
    Allied Universal (09/27/24)
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  • Part Time Private Investigator

    The Robison Group (Memphis, TN)
    …opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU Investigator , you will be joining an incredible team ... are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire… more
    The Robison Group (09/25/24)
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  • Sr. Fraud Investigator ( SIU )

    Kelsey-Seybold Clinic (Pearland, TX)
    **Responsibilities** The Sr. Fraud Investigator SIU ( Special Investigations Unit ) assists in the implementation and daily operation of the ... audits and investigations conducted **Job Title: Sr. Fraud Investigator ( SIU )** **Location: Pearland Administrative Office** **Department:** **Health Plan… more
    Kelsey-Seybold Clinic (09/05/24)
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  • Investigator , SIU -Must Reside in

    Molina Healthcare (New York, NY)
    **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw… more
    Molina Healthcare (08/07/24)
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  • Mid-level SIU investigator

    USAA (Toledo, OH)
    …laws and regulations and policies and procedures. **The Opportunity** As a dedicated SIU investigator , within defined guidelines and framework, you will protect ... School Diploma or General Equivalency Diploma. + 2 years claims adjusting experience, or P&C SIU /Fraud Investigation...terminology. **What sets you apart:** + Current or prior SIU investigations experience working in diverse teams… more
    USAA (09/25/24)
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  • Investigator , Coding SIU (Remote)

    Molina Healthcare (Owensboro, KY)
    **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of...5+ years of experience working in a FWA / SIU or Fraud investigations role for New… more
    Molina Healthcare (09/18/24)
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  • SIU Research Investigator

    Sedgwick (Naperville, IL)
    SIU Research Investigator **PRIMARY PURPOSE** **:** To perform claims investigations utilizing online public and subscription database searches; to ... ensures investigations are completed according to service expectations and SIU best practices. + Maintains technical competency and adherence with all applicable… more
    Sedgwick (09/14/24)
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  • Senior Manager, Special Investigation…

    Premera Blue Cross (Mountlake Terrace, WA)
    …15 miles north of Seattle, Washington.** **What you'll do:** + Lead Premera's Special Investigations Unit in driving the development, implementation, and ... blog: https://healthsource.premera.com . As a **Senior Manager of the Special Investigation Unit ( SIU )** ,...case files. + In-depth knowledge of the insurance industry, Special Investigation Unit operations, claims more
    Premera Blue Cross (07/24/24)
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  • SIU Investigator

    Centene Corporation (Trenton, NJ)
    …healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential ... healthcare fraud and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document...mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect… more
    Centene Corporation (09/27/24)
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  • Investigator , Special Investigation…

    Providence (CA)
    …will:** + Support timely completion of compliance related audits and investigations of the Special Investigations Unit ( SIU ) at the Health Plan + ... must empower them._** **Providence Health Plan is calling an Investigator , Special Investigation Unit who...multiple cases and audits simultaneously + May assist Senior Investigator or SIU Director in developing, implementing… more
    Providence (09/26/24)
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  • FWA Investigator Coder Sr. Associate…

    Commonwealth Care Alliance (Boston, MA)
    … Coder Sr. Associate is an integral part of the Fraud, Waste & Abuse (FWA) Special Investigation Unit ( SIU ). The position reports directly to the Sr. ... CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and applies… more
    Commonwealth Care Alliance (08/13/24)
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  • Special Investigator (Healthcare…

    AmeriHealth Caritas (Dublin, OH)
    ** Special Investigator (Healthcare Fraud, Waste & Abuse)- Ohio resident** Location: Dublin, OH Primary Job Function: Compliance ID**: 34748 **Job Brief** This ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of… more
    AmeriHealth Caritas (09/20/24)
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  • Senior Nurse Investigator (Hybrid)

    CareFirst (Baltimore, MD)
    …+ Perform special projects to meet the objectives of the Special Investigations Unit . **QUALIFICATIONS:** **Education Level:** Bachelor's Degree OR ... of losses to CareFirst through the clinical review of medical records and claims , resulting in the savings and/or recovery of funds. Responsible for providing… more
    CareFirst (09/27/24)
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  • Surveillance Investigator

    Allied Universal (Cordele, GA)
    Investigator 's license prior to applying.** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
    Allied Universal (09/27/24)
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  • Surveillance Investigator - Part-Time

    Allied Universal (Lincoln, NE)
    …'s license** **required** **prior to applying** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
    Allied Universal (09/18/24)
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  • Surveillance Investigator

    The Robison Group (Albany, NY)
    Individuals selected for the position will be expected to perform investigations of workers compensation claims , liability investigations , multi-line ... We are looking for people who are enthusiastic about investigations , those who thrive in a diverse work environment,...willing and able to obtain a New York Private Investigator license. + Self-motivated, determined, and intuitive. + Strong… more
    The Robison Group (08/15/24)
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