- 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+ ... exclusive perks. Allied Universal(R) is hiring a Surveillance / Claims Investigator . Surveillance / Claims ...of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims… more
- 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 (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 (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
- Allied Universal (Durango, CO)
- …retirement plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Claims / SIU Investigator . Claims / SIU ... offering field and remote work ** + **Will** **require** ** Claims and Surveillance investigations as needed to...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- The Robison Group (Columbia, SC)
- …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
- Humana (Columbia, SC)
- …help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Senior Fraud and ... by ACFE + Currently designated as an Accredited Health Care Fraud Investigator (AHFI) granted by NHCAA + Investigative/Law Enforcement background + Other medical… more
- CVS Health (Des Moines, IA)
- …flexible to work CT hours (8:00 am - 5 pm CT) Conducts investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare ... will do:** + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business +...in identifying resources and best course of action on investigations + Serves as back up to the Team… more
- 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
- Molina Healthcare (Louisville, KY)
- **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 (New York, NY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager, SIU , the Team Lead is responsible to lead a small team of investigators and provide ... on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking...Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight… more
- 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
- 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
- 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
- Centene Corporation (Atlanta, GA)
- …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
- Providence (OR)
- …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
- 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
- Allied Universal (Nashville, TN)
- …'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 (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
- 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