- 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
- 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
- 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 ... in identifying resources and best course of action on investigations + Serves as back up to the Team...fraud and abuse matters. + Working knowledge of medical coding ; CPT, HCPCS, ICD10 + Proficiency in Microsoft Office… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... also include coding and billing reviews. The SIU Investigator is responsible for reviewing and...assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background… more
- 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
- 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...involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
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