- Capital One (Richmond, VA)
- AML Sr. Investigator I - Special Investigations Unit **AML Sr. Investigator I - Special Investigations Unit ** The Anti-Money Laundering ... investigations or other AML processes. The AML Sr Investigator I will work closely with AML Supervisors and...Supervisors and Managers to perform other critical functions. The Special Investigations Unit conducts suspicious… more
- Allied Universal (Alexandria, LA)
- …the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator . Special ... and case managers, by means of data collection, interviews, research and collaboration with other SIU entities,...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- CVS Health (Nashville, TN)
- …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...how to do pivot tables). + Strong analytical and research skills. + Proficient in researching information and identifying… more
- CVS Health (Oklahoma City, OK)
- …of Oklahoma. Must be willing to work CDT schedule. - Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud ... to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. -… more
- Blue KC (Kansas City, MO)
- …**Job Description Summary:** As part of Blue KC's Special Investigations Unit ( SIU ), the Fraud Investigator conducts reviews to identify potential ... of fraud, waste and abuse in accordance with SIU policies and procedures. May work with Manager and/or...policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations . +… more
- Point32Health (Canton, MA)
- … I is an essential team member of the Special Investigation Init ( SIU ( Special Investigations Unit )) responsible for leading complex provider ... The Investigator works closely with other members of the SIU to set investigative priorities, develop effective investigative strategies and techniques, and… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... that may 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 ... requirements. Primary activities include substantiating referrals, case planning and research , conducting onsite or desk audits, clinical reviews of...criminal justice or related field; or employment as an investigator in the SIU on or before… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator ... to join the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving providers who submit… 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
- Allied Universal (Billings, MT)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... clients and case managers through various methods such as data collection, interviews, research , and scene investigations + Follow guidance from the handling… more
- AmeriHealth Caritas (Columbus, OH)
- … investigations . + Performs necessary functions to support all aspects of SIU investigations and responsibilities to include, but not limited to: Intake; ... Special Investigation Units and fraud, waste and abuse investigations . + Conducts investigations of potential; fraud,...in lieu of formal educational requirements for the Lead SIU Investigator position may be considered.; +… more