• SIU Investigator

    NTT DATA North America (Boston, MA)
    …strategy. NTT DATA's Client is seeking a Investigator for Health Plan Special Investigations Unit ( " SIU ) REMOTE EAST COAST The Investigator ... and work closely with other members of the SIU . Reviews are fast-paced and require the investigator...Qualifications: 1-3 year's related experience in health insurance fraud investigations , health insurance coding , provider relations, or… more
    NTT DATA North America (08/26/25)
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  • Special Investigation Unit Lead…

    CVS Health (Nashville, TN)
    …all with heart, each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the ... in identifying resources and best course of action on investigations . - Cooperates with federal, state, and local law...Fraud, Waste and Abuse investigatory experience. * Billing and Coding certifications such as CPC (AAPC)and/or CCS… more
    CVS Health (09/20/25)
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  • Medical Investigator I/II

    Excellus BlueCross BlueShield (Rochester, NY)
    …OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall ... criminal justice or related field; or employment as an investigator in the SIU on or before...and supporting systems. (BREADTH). + Expertise in complex clinical coding /reviewing assignments, difficult investigations and highly visible… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Clinical Investigator

    MVP Health Care (Rochester, NY)
    …York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC credential. + Maintain ... improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for...if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication… more
    MVP Health Care (09/20/25)
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