- The Robison Group (Salt Lake City, UT)
- …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
- Capital One (Mclean, VA)
- …(19050), United States of America, McLean, Virginia Anti-Money Laundering Subject Matter Expert (SME) - Special Investigations Unit ( SIU ) The Special ... Investigations Unit in the AML Department performs specialized investigations to assess risks presented in particular circumstances. A Subject Matter Expert… more
- Humana (Indianapolis, IN)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... Program Integrity (OMPP PI) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in Ohio to increase… more
- Allied Universal (Fairfax, VA)
- …employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator . Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… more
- Humana (Columbus, OH)
- …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 (ID)
- **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
- CVS Health (Tallahassee, FL)
- …an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ). In this role, you will manage complex ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.… more
- Kemper (Miami, FL)
- …stakeholders that delivers on our promises._ **Position Summary:** The SIU Investigator will conduct field and desk investigations of insurance claims ... accepted for investigation by the Special Investigative Unit . Our Special Investigator will...Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department… more
- Kemper (Lake Mary, FL)
- …claims referred to and accepted for investigation by the Special Investigative Unit . Our Special Investigator will function as an investigator ... Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department...agencies as required by law and management. Keeps the Special Investigation Unit and field managers advised… more
- Molina Healthcare (Columbus, OH)
- **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
- Insight Global (San Antonio, TX)
- …well as monitor appropriate loss and expense claims reserves. As a Mid-Level Life SIU Investigator for Medicare Supplement Fraud, Waste, and Abuse you will ... San Antonio, TX area is looking for a remote SIU Life and Health investigator . As a...support the Life Special Investigations team that is responsible for… more
- Molina Healthcare (KY)
- **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
- Command Investigations (Orlando, FL)
- Seeking a full-time experienced SIU /Insurance investigator . A minimum of 3 years' experience as an insurance Investigator is required. Must have background ... in handling multi-lines investigations and some SIU experience. Must have...a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the… more
- Command Investigations (Ventura County, CA)
- Experienced SIU Investigator A minimum of 5 years' SIU experience is required. Must have background in handling P&C investigations . Candidates who do not ... and staff. This is a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the following areas: + P&C… more
- Command Investigations (San Diego, CA)
- SIU INVESTIGATOR A minimum of 5...is required. Must have experience in Commercial and P&C investigations . * Candidates who do not have property (non-auto) ... a W-2 role; subcontractors will not be considered. The SIU Investigator should demonstrate proficiency in the...should demonstrate proficiency in the following areas: + P&C investigations , with all lines preferred. + Writing accurate and… more
- CVS Health (Frankfort, KY)
- …are seeking an experienced Senior Healthcare Fraud Investigator (Pharmacy) to join our Special Investigations Unit . In this role, you will manage complex ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conducts high level, complex investigations of known or suspected acts of Pharmacy Fraud, Waste and Abuse. +… more
- City of New York (New York, NY)
- …The New York City Department of Correction seeks to recruit Investigators for the Special Investigation Unit ( SIU )- PREA Team. The Prison Rape Elimination ... September 4, 2003. Under the direction of a Supervisor Investigator for the SIU PREA and with...engaged in the performance of confidential, highly complex, and/or special investigations involving surveillance, interrogation of subjects… more
- Molina Healthcare (Columbus, OH)
- **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
- Travelers Insurance Company (Alpharetta, GA)
- …and expertise to identify potential risks and combat fraudulent practices. As an SIU Investigator , you will analyze, summarize and prioritize information to ... claims deemed suspicious in nature within all lines of business. The investigator will conduct thorough and comprehensive investigations in a dynamic,… more
- Elevance Health (Mason, OH)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud &...clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims… more