- Allied Solutions (Plano, TX)
- …and exceed all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …to perform interviews and obtain medical records/ and other relevant documentation. The Senior Investigator will also act as subject matter expert in researching ... **Responsibilities** The Sr . Fraud Investigator SIU (Special Investigations...experience Preferred: N/A **Experience** Required: 4+ years' experience in claims examination, adjusting, fraud detection, or investigations in a… more
- Kaleida Health (Buffalo, NY)
- …and consistent with the Mission, Vision and Values of Kaleida Health. The Sr . HR Investigator will be responsible for reviewing complaints and planning, ... to conduct investigations in a thorough and objective manner to provide recommendations. The Sr . HR Investigator will partner with the VP Labor & Employment… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr . Associate is an integral part of the Fraud, Waste & Abuse (FWA) ... with providers, and other CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review,… more
- Indy Gov (Indianapolis, IN)
- …senior litigation attorneys, two deputy chief litigation counsels, a tort claims investigator , paralegals, and office administrative staff. Working in ... diverse array of litigation matters, including federal civil rights suits, tort claims , contract disputes, prisoner litigation, appeals at the state and federal… more
- Saia, Inc (Fontana, CA)
- …issues and clear shipments. + Identifies and reviews target accounts with multiple claims due to damage or loss. + Conducts investigations with destination terminals ... to resolve and prevent claims . + Collaborates with terminal management to identify and...noncompliance in overage, shortage, and damaged procedures to prevent claims and delivery delays. + Serves as an OS&D… more
- Elevance Health (Indianapolis, IN)
- ** Senior Investigator ( Investigator Sr )** _Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 ... to recover, eliminate, and prevent unnecessary medical-expense spending. The ** Senior Investigator ** is responsible for the independent...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- EFI Global (St. Paul, MN)
- …requirements for consideration.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, ... large fire loss, and multiple claims .** **Ensures that assigned cases are investigated and reported back to the requesting party in adherence to best practices.… more
- EFI Global (Knoxville, TN)
- …buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud, this includes large loss, large ... fire loss, and multiple claims . + Ensures that assigned cases are investigated and...ethical manner. + May provide investigative guidance to Fire Investigator team members. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
- Elevance Health (Columbus, OH)
- ** Investigator Senior ** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior ** is responsible for the independent...to recover corporate and client funds paid on fraudulent claims . **How will you make an impact:** + Claim… more
- Cambridge Savings Bank (Waltham, MA)
- …investigative strategies, and ensure compliance with regulatory requirements. The Senior Investigator must have excellent communication, prioritization, and ... POSITION: Senior Fraud Investigator Summary: At Cambridge...law enforcement. + Expertise in investigative tactics, fraud analysis, claims , and recovery process. + Experience with gathering, handling,… more
- City of New York (New York, NY)
- …in their agreement to repay. Claims &Collection is recruiting for (4) four Fraud Investigator II to function as a Senior Fraud Investigator , who will: - ... Job Description Claims and Collections pursues monetary recoveries owed to...and one year of satisfactory, full-time experience as an investigator as described in "1" above; or 3. A… more
- Medical Mutual of Ohio (Rossford, OH)
- …consistency with policy and procedures. . Performs other duties as assigned. ** Senior Financial Investigator ** Pursues criminal fraud and prevents future ... subtraction, percentages, fractions. . Knowledge of medical terminology and coding. ** Senior Financial Investigator ** . Bachelor's Degree in Criminal Justice,… more
- University of Rochester (Rochester, NY)
- GENERAL PURPOSE: The Equal Employment Opportunity and Title IX Investigator (EEO/Title IX Investigator ) serves as part of a team investigating and resolving ... the University's legal obligations to address discrimination and harassment claims and sexual misconduct. Document findings as to the...Officer and Associate VP for Equity & Inclusion and Sr . Associate Dean for Equity & Inclusion SMD, the… more
- Elevance Health (Nashville, TN)
- ** Investigator II - Carelon Payment Integrity** **Location** : The ideal candidate will live within 50 miles of one of our OH, TN, or IN offices and will work on a ... determined to recover, eliminate, and prevent unnecessary medical-expense spending. ** Investigator II** is responsible for the identification, investigation, and… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Department Quality Management Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... recommendations. 5. In conjunction with the assigned Incident Management Investigator Specialist, prepares investigative reports and forwards completed reports to… more
- Providence (OR)
- …manage a workload with multiple cases and audits simultaneously + May assist Senior Investigator or SIU Director in developing, implementing and performing ... people, we must empower them._** **Providence Health Plan is calling an Investigator , Special Investigation Unit who will:** + Support timely completion of… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Specialist Department Quality Management Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=6105) Job Brief Assists the Incident Management Investigator with conducting investigations into situations, which may violate… more
- Elevance Health (Atlanta, GA)
- ** Investigator II - Carelon Payment Integrity** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... to recover, eliminate, and prevent unnecessary medical-expense spending. The ** Investigator II** is responsible for the identification, investigation and development… more
- Elevance Health (FL)
- Job Description ** Investigator II** **Supporting the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator II** is responsible for the identification, investigation and development… more