- USAA (Phoenix, AZ)
- …us special and impactful. The Opportunity We are looking for a Manager, SIU ( Special Investigations Unit ) within P&C. Responsible for operational ... and decisions to carry out proactive claim's projects and investigations . Reviews and evaluates investigation recommendations from...other risks. 4+ years of progressive experience within a Special Investigations Unit ( SIU… more
- Allstate (New York, NY)
- …discovery, arbitrations, motion practice, pre-trial negotiations, and courtroom advocacy. Conduct Special Investigation Unit ( SIU ) Examinations ... Under Oath (EUOs) and prepare comprehensive reports with a focus on SIU and Personal Injury Protection (PIP) matters. Review new file assignments, analyze evidence,… more
- Allstate (New York, NY)
- …case evaluation, discovery, motion practice, arbitrations, mediations, and settlement negotiations. Conduct Special Investigation Unit ( SIU ) Examinations ... (EUOs) and prepare comprehensive reports with a focus on SIU and Personal Injury Protection (PIP) matters. Review new...position will be required to submit to a background investigation . Joining our team isn't just a job -… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …and communicate audit results and will collaborate with internal teams including the Special Investigation Unit and Payment Integrity Specialists. This role ... + Collaborate with internal teams (eg, claims processing, provider relations, special investigations unit ). + Utilize auditing software and systems to… more
- USAA (Tampa, FL)
- …adverse carrier). Identifies coverage concerns, reviews prior loss history, determines, and creates Special Investigation Unit ( SIU ) referrals, when ... we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Complex Auto Adjuster, you will adjust… more
- USAA (Phoenix, AZ)
- …adverse carrier). Identifies coverage concerns, reviews prior loss history, determines, and creates Special Investigation Unit ( SIU ) referrals, when ... we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Auto Adjuster you will proactively handle… more
- USAA (New York, NY)
- …us special and impactful. **The Opportunity** We are looking for a Manager, SIU ( Special Investigations Unit ) within P&C. Responsible for operational ... and decisions to carry out proactive claim's projects and investigations . + Reviews and evaluates investigation recommendations...risks. + 4+ years of progressive experience within a Special Investigations Unit ( SIU… more
- Providence (Oakland, CA)
- **Description** **Investigator External Audit Special Investigations Unit \*Remote The SIU Audit Investigator supports the compliance related activities ... of the Special Investigations Unit ( SIU...activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and… more
- The Robison Group (Brooklyn, NY)
- …writing, reading and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and...+ Make sound judgments during the course of the investigation . + Provide timely progress updates. + Complete detailed… more
- Elevance Health (Cleveland, OH)
- …recover, eliminate and prevent unnecessary medical-expense spending. **Staff Vice President (VP), Special Investigations Unit ( SIU )** **Location:** May ... the national SIU . + Functions within the SIU include investigations , case intake and assignment,...administration, or related field and minimum of 10 years investigation , prosecution, or healthcare experience; or any combination of… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. The **Senior RFI Analyst** within the Special Investigations Unit ( SIU ) plays a key role in supporting ... fraud, waste, and abuse investigations by managing and responding to Requests for Information...Medicaid and Medicare programs - Familiarity with state-specific fraud investigation protocols (eg, Texas OIG, Florida AHCA) - Prior… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... SIU related requirements. Prepares detailed preliminary and extensive investigation referrals to state and/or federal regulatory and/or law enforcement agencies… more
- Geisinger (Danville, PA)
- …Responsible for the strategic direction, planning, oversight, and operation of the Special Investigations ("SI") and Program Integrity ("PI") teams. Develops and ... directs the prevention, detection and investigation of anti-fraud, waste and abuse (FWA)program processes and...Job Duties + Provides leadership and strategic direction of Special Investigations and Program Integrity units spanning… more
- Centene Corporation (Jefferson City, MO)
- …correcting fraud, waste, and abuse ("FWA") in healthcare billing through investigation and coordination with internal and external stakeholders. Responsible for ... and executing strategies that ensure high-quality, timely, value-generating FWA investigations in compliance with legal, regulatory, and contractual requirements.… more
- Molina Healthcare (Milwaukee, WI)
- …hospital, clinic settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical… more
- Molina Healthcare (Louisville, KY)
- … investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the SIU referral intake and investigation process while giving guidance and ... direction to team on case investigation steps and actions. + Works with leadership to maintain and revise policies and procedures, fraud, waste, and abuse plans,… more
- Allied Universal (Edison, NJ)
- …on the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor **QUALIFICATIONS (MUST HAVE):**… more
- Capital One (Mclean, VA)
- AML Sr Investigator II- SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized investigations ... (SME)** will work closely with key stakeholders in the SIU and outside of the SIU when...+ Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in… more
- U-Haul (Phoenix, AZ)
- …+ 1 year of employment with U-Haul/Repwest Work Status: Full-time U-Haul offers its Special Investigation Unit : + Full Medical coverage + Prescription plans ... Regional Claims Manager, Repwest Insurance Company, responsible for the identification, investigation , and prosecution of fraudulent intent by all persons directed… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The Special Investigations Unit ( SIU ) Investigator is responsible to conduct timely and thorough health care fraud investigations ... - $111,800.00 **Skills** Depositions, Evidence Collection, Forensic Accounting, Fraud Investigations , Investigation Techniques, Investigative Analysis, Job Interviews,… more
