- Allied Universal (Fargo, ND)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... **Job Description:** 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 (San Diego, CA)
- CLAIMS INVESTIGATOR Seeking an experienced investigator with multi-lines investigations to include W/C and P&C experience. SIU experience is also ... website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the...proficiency in the following areas: + W/C and P&C investigations + Writing accurate, detailed reports + Strong initiative,… more
- Command Investigations (San Jose, 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 (Las Vegas, NV)
- …depending on the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Claims / SIU Investigator . Claims / SIU Specialists ... five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims +...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… 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...with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required, as… more
- The Robison Group (Oklahoma City, OK)
- …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
- 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 ... to conduct pre-payment reviews of medical records for healthcare claims in one or more of the following areas:... and work closely with other members of the SIU . Reviews are fast-paced and require the investigator… more
- Command Investigations (Baltimore, MD)
- Seeking experienced Claims / SIU and/or Workers' Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and ... and staff. Must have a background in handling multi-lines investigations with personal lines highly desired. Must have reliable...our website and find out why at www.GoCommand.com. The SIU /WC Investigator should demonstrate proficiency in the… more
- Elevance Health (Richmond, VA)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Clinical Fraud Investigator II - Registered Nurse and CPC -...investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines… more
- Travelers Insurance Company (Diamond Bar, CA)
- …and combat fraudulent practices at scale. As an SIU Specialized Investigator , you will lead complex, multi-claim investigations with regional and national ... provides industry-leading resources designed to detect and deter fraudulent claims . Leveraging advanced technology and analytics, we proactively identify risk… more
- CVS Health (Charleston, WV)
- …every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known ... fraud schemes. + 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
- Centene Corporation (Sacramento, CA)
- …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
- CVS Health (Harrisburg, PA)
- …all with heart, each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- Molina Healthcare (Lexington, 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
- Command Investigations (Detroit, MI)
- …) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator . SuperiorX Investigations ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- MVP Health Care (Rochester, 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 ... a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication...related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation… more
- Allied Universal (Crestview, FL)
- …with at least one year of driving experience** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, ... **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and… more
- The Robison Group (Omaha, NE)
- 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,...POSITION QUALIFICATIONS: + A current and valid Nebraska Private Investigator license is highly preferred. Ability to obtain an… more
- CVS Health (Albany, NY)
- …Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's Special Investigations Unit . In this role, you will manage ... + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and prepares… 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 ... flexible to work EDT hours (8:00 am - 5 pm EDT) Conducts investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare… more