- System One (Baltimore, MD)
- …support a leading health insurance customer. The individual will work with the Special Investigations Unit ( SIU ) to assist in the reduction and ... valued partner for our clients, but we offer eligible full-time employees health and welfare benefits coverage options including medical, dental, vision, spending… more
- CVS Health (Springfield, IL)
- … care more personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of known or ... *Bachelor's degree or an additional 5 years of working health care fraud, waste and abuse investigations ....eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long… more
- National General Insurance Company (TX)
- …Antonio, or Austin, TX area. The ideal candidate will have previous experience as an SIU Investigator within an Insurance carrier. JOB SUMMARYThis job is ... coverage and claims that have been referred to the special investigation unit ( SIU ) for...and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health , and other niche insurance products. We… more
- LTCG (MN)
- …and success of its customers. With illumifin, there's a brighter future A SIU /Fraud Investigator is responsible for working with multiple business units on ... from claims organization, as assigned * Coordinates and performs investigations with oversight of lead investigator *...of medical terminology * Experience in fraud detection and investigations within the long-term care or health … more
- CVS Health (Hartford, CT)
- …- Exhibits behaviors outlined in Employee Competencies - Exhibits behaviors outlined in SIU Investigator Competencies - May include travel to testify in court ... Bring your heart to CVS Health . Every one of us at CVS ...EDT hours (8:00 am - 5 pm EDT) Conducts investigations to effectively pursue the prevention, detection, investigation and… more
- American Family Insurance - Corporate (Orlando, FL)
- …multi-line claims, build and maintain meaningful industry social network and assist special investigations leadership in promoting fraud awareness and detection ... with internal partners, agents, and customers. Reporting to the SIU Manager, you will work in the field and...+ Communicate with internal and external business partners regarding investigations and insurance fraud matters. + Develop… more
- Commonwealth Care Alliance (Boston, MA)
- …background or formal data analyst background preferred. + Prior experience in health care compliance, regulation, SIU , government agency or similar position ... **Why This Role is Important to Us:** The Associate Investigator works with a growing team conducting and managing... works with a growing team conducting and managing Health Care Fraud, Waste and Abuse investigation and prevention… more
- CVS Health (Baton Rouge, LA)
- …health care more personal, convenient and affordable. Position SummaryAs a Senior Investigator you will conduct high level, complex investigations of known or ... Bachelor's degree or an additional 5 years of working health care fraud, waste and abuse investigations ....eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long… more
- CVS Health (Hartford, CT)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...EDT hours (8:00 am - 5 pm EDT) Conducts investigations to effectively pursue the prevention, detection, investigation and… more
- CVS Health (Hartford, CT)
- …- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud, waste, and abuse investigations and audits. Pay Range ... Bring your heart to CVS Health . Every one of us at CVS ...Must be willing to work EDT schedule. - Conducts investigations to effectively pursue the prevention, investigation, and prosecution… more
- CVS Health (Trenton, NJ)
- …- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud, waste, and abuse investigations and audits. Pay Range ... Bring your heart to CVS Health . Every one of us at CVS ...care more personal, convenient and affordable. Position Summary- Conducts investigations to effectively pursue the prevention, investigation, and prosecution… more
- CareFirst (Baltimore, MD)
- …programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Special Investigations Unit **Equal Employment Opportunity** ... processing, b) customer service function or equivalent experience in investigative, health care, nursing, law enforcement or insurance . **Preferred… more
- Premera Blue Cross (Spokane, WA)
- …https://healthsource.premera.com . As a member of Premera's Special Investigations Unit ( SIU ), the ** Investigator III** will be responsible for ... government plan auditing experience preferred. + Strong understanding of health insurance reimbursement methodologies, including familiarity with International… 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. ... (Word, Excel, PowerPoint, and Access). **Desired Experience:** + Prior experience in health care compliance, regulation, SIU , government agency or similar… more
- CDPHP (Albany, NY)
- …you to be a part of that experience. The SIU Special Investigator will be responsible for investigating complex insurance cases to detect internal and ... not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York....procedures, and State and Federal laws pertaining to the health care industry. The Special Investigator… more
- The Cigna Group (Sunrise, FL)
- As a Junior Fraud Investigator for Cigna's Special Investigations Unit , you'll support our US Commercial Healthcare Business in conducting and supporting ... field (Economic Crime) + 0-2 years professional work experience, preferably with health insurance investigations /audit + Outstanding technical & analytical… more
- Manulife (Boston, MA)
- …squads to drive savings associated with fraud, waste & abuse. The Senior LTC Investigator will conduct desktop investigations of high complexity related to LTC ... Ability to apply a working knowledge of state laws and regulations related to insurance fraud and SIU requirements + Experience testifying in legal proceedings… more
- Travelers Insurance Company (Melville, NY)
- …claims. + Valid driver's license required. **What Is in It for You?** + ** Health Insurance ** : Employees and their eligible family members - including spouses, ... and industry alerts, leads from lines of business, etc.). + Conducts thorough insurance field investigations while managing resources with a focus on uncovering… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …+ Experience conducting fraud investigations , working in an insurance company Special Investigations Unit ( SIU ) or Insurance Compliance. ... (CID (https://portal.ct.gov/cid?language=en\_US) ) is currently accepting applications for an Insurance Associate Examiner (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=1781AR&R1=&R3=) within the Fraud Unit… more
- American Family Insurance - Corporate (Madison, WI)
- …participating in special investigation industry associations and collaborating with special investigation industry peers to combat insurance fraud activity. ... The SIU Manager leads a multi-functional team including Triage...organization mission, vision, values, policies, and practices. + Assess investigator resource capabilities and capacity to determine resource needs.… more