- Allied Universal (Cape Coral, FL)
- …explore a career with us and make a difference. Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for ... Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...database information found in systems such as Unitrac, insurance company websites, Lexis Nexis, ISO, and other automobile databases… more
- NJ Transit (Newark, NJ)
- Investigator A ( Claims ) Finance Job Description: Move forward with us! At NJ TRANSIT, you'll join us in transforming the third-largest transportation agency in ... public agencies. + Carrying out negotiations in adjusting of claims and entering of settlements with attorneys. + Obtaining...a diary system. + Maintaining both paper and electronic claim files. + Attending trials as liaison between defense… more
- Command Investigations (TN)
- …hire. Visit our website and find out why at www.GoCommand.com . The Claims /Surveillance Investigator should demonstrate proficiency in the following areas: + ... Command Investigations LLC is a dynamic and forward-thinking investigative company that has been at the forefront of the...skills. Job Requirements: + Able to obtain a Private Investigator license. + Possession of a high school diploma… more
- Allied Universal (Provo, UT)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... difference. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with… more
- Kemper (Doral, FL)
- … investigator must possess oral and written communications skills and promote a favorable company image to the public. + Fraud Claims Law Specialist (FCLS) or ... that delivers on our promises._ **Position Summary:** The SIU Investigator will conduct field as well as desk investigations...conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the… more
- Allied Universal (Boca Raton, FL)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
- Elevance Health (Indianapolis, IN)
- …eliminate and prevent unnecessary medical-expense spending. **Title:** Sr Investigator **Locations:** Indianapolis, IN, Columbus, OH, Nashville, TN **Hybrid:** ... unless an accommodation is granted as required by law. The **Sr Investigator ** is responsible for the independent identification, investigation and development of… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... justice or a related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation experience with law… more
- Sanford Health (Fargo, ND)
- …investigation/audit. - Master's Degree preferred - Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred - ... Responsible for conducting audits and investigations of potentially fraudulent claim activity. Will plan, develop, and implement investigative processes and… more
- Humana (Oklahoma City, OK)
- …first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of Investigators conducts ... of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As...line of business. As the Senior Fraud and Waste Investigator , you will serve as Humana's Program Integrity Officer,… more
- Humana (Dayton, OH)
- …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 ... outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the program integrity … more
- AmeriHealth Caritas (Columbia, SC)
- …services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported, ... Proactively performs research using the Internet, data analysis tools, etc., to analyze aberrant; claims billing and practice patterns. + Analyzes data as part of the… more
- The Robison Group (Albany, NY)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... Candidates must be willing and able to obtain a New York Private Investigator license. + Self-motivated, determined, and intuitive. + Strong initiative and work… more
- Point32Health (Canton, MA)
- …about who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Investigator I is an essential team member of the Special Investigation Unit ... ("FWA") investigations under the direction of the Manager, FWA Prepayment Review. The Investigator I works closely with other members of the SIU to set investigative… more
- Elevance Health (St. Louis, MO)
- …in order to recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible for identifying and developing ... specific healthcare investigations that may impact more than one company health plan, line of business and/or state +... health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review,… more
- CVS Health (Columbus, OH)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of...fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business +… more
- Command Investigations (Syracuse, NY)
- $500 SIGN ON BONUS AIC Companies, a modern, innovative, and results-driven company that focuses on client satisfaction and employee happiness is looking for entry ... website for additional information on our investigative offerings and company background (www.aiccompanies.com). Job Description: Surveillance Investigators are the… more
- Highmark Health (Pittsburgh, PA)
- ** Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for developing and maintaining an anti-fraud program which includes ... Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment… more
- CVS Health (Topeka, KS)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a… more