- Molina Healthcare (Cleveland, OH)
- **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
- Molina Healthcare (Cleveland, OH)
- …responsible to lead a small team of investigators and provide oversight on daily investigative activities as a back-up to the SIU Manager. This position will be ... complete and signed-off + Provide guidance to investigators as needed on investigative techniques, tools, or strategy. + Effectively investigate and manage complex… more
- Molina Healthcare (Cleveland, OH)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... providers. This position uses information from a tip, member benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely turn around. This position… more
- Humana (Independence, OH)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities...Integrity + Cooperate effectively with federal, state, and local investigative agencies on FWA cases to ensure best outcomes;… more
- USAA (Cleveland, OH)
- …makes us special and impactful. **The Opportunity** As a dedicated **Manager, Special Investigations Unit for Property & Casualty** , you will be responsible ... investigative tools and techniques to guide and coach special investigators. + Proven ability to build and maintain...**What sets you apart:** + 2+ years of SIU investigator experience. + Current or prior SIU leadership experience… more