- 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
- 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
- Allied Universal (Dallas, TX)
- **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... and eligibility. **Job Description:** Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet mobile and… more
- Elevance Health (Grand Prairie, TX)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that… 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
- Health Care Service Corporation (Richardson, TX)
- …medical, contractual, legislative, policy, and other information to validate claims submitted and billed. Conducting research; preparing documentation of findings ... or acquire within 24 months of hire** **3 years experience in claims processing operations and reporting systems, including 2 years experience in auditing… more
- Honeywell (Richardson, TX)
- …to our customers. Product Integrity supports accident investigations and product liability claims in the rare instances when product safety has not met customer, ... Honeywell, or regulatory standards and requirements. Product Integrity drives timely corrective action to ensure the safety of Honeywell Sensing Solutions products. Reports directly to IA Quality Leader Significant interaction and collaboration required with… more