- 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...will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim… more
- Elevance Health (Grand Prairie, TX)
- **Carelon Coordination of Benefits (COB) - Investigator II** Internal Job Title: Financial Operations Recovery Specialist II **Location:** This role enables ... expenses, making a significant impact on our mission. The **Carelon COB Investigator II (** Financial Operations Recovery Specialist II) is tasked with conducting… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
- Elevance Health (Grand Prairie, TX)
- ** Investigator Senior** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per week, ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- Allied Universal (Dallas, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... cover fuel and travel expenses** Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet mobile and… more
- Elevance Health (Grand Prairie, TX)
- ** Investigator II** **Location:** _Hybrid1_ : This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, while ... dynamic and adaptable workplace. Alternate locations may be considered. The ** Investigator II** is responsible for the identification, investigation and development… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims… more
- Travelers Insurance Company (Richardson, TX)
- …provides industry-leading resources designed to detect and deter fraudulent claims . Leveraging advanced technology and analytics, we proactively identify risk ... and combat fraudulent practices at scale. As an SIU Specialized Investigator , you will lead complex, multi-claim investigations with regional and national… more
- TIAA (Frisco, TX)
- **Financial Crimes Investigator ** The Fraud Operations Analyst II at TIAA will support the detection, investigation, and mitigation of financial crimes and fraud ... to inbound fraud-related calls from clients and associates. Research customer claims and gather evidence to support investigative findings. + Provide detailed… more
- Kemper (Dallas, TX)
- …College Degree or equivalent work experience * Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong ... and/or Analytics Academies are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA)… more
- Wells Fargo (Irving, TX)
- …within Consumer, Small Business Banking (CSBB) Operations and Fraud and Claims Management (FCM) with analytic insights, data visualization, risk, regulatory and ... approach to reporting in support of the Fraud and Claims Management team. + Partners in the development of...SAS experience, including SAS Visual Analytics and/or SAS Visual Investigator + Demonstrated SQL skills to include the ability… more