- 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
- Command Investigations (Laredo, TX)
- …for hire. Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, ... Auto, or Homeowners Investigations. + Writing accurate, detailed reports + Strong initiative, integrity, and work ethic + Securing written/recorded statements + Accident scene investigations + Possession of a valid driver's license + Ability to prioritize and… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** SIU Investigator **Job Description** The Special Investigations Unit (SIU) Investigator is ... and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively… more
- Molina Healthcare (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** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, while providing flexibility ... and adaptable workplace. Alternate locations may be considered. The ** Investigator Sr.** position is responsible for the independent identification, investigation… more
- Elevance Health (Grand Prairie, TX)
- ** Investigator Senior** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office)._ _Alternate ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to make medical determinations… more
- Allied Universal (Odessa, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... programs, and exclusive perks. Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet mobile and… more
- Allied Universal (Waco, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... programs, and exclusive perks. Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet mobile and… more
- DHS Headquarters (Grand Prairie, TX)
- …requirements must be met by the closing date of this announcement. Qualification claims will be subject to verification. NOTE: Experience refers to paid and unpaid ... will remain in effect while assigned to this position as a criminal investigator . Motor Vehicle Operation: Incumbent must possess and maintain a valid motor vehicle… more
- The Hartford (San Antonio, TX)
- SIU Desk Investigator - CF08JE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... SIU Desk InvestigatorA new role as an SIU Desk Investigator at The Hartford offers a unique opportunity to...of insureds, claimants and industry related providers.* Proactively review claims to identify red flags through database research and… more
- Sedgwick (Houston, TX)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance SIU Research Investigator **PRIMARY PURPOSE** **:** To perform claims investigations utilizing ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- The Robison Group (San Antonio, TX)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... + Candidates must be willing and able to obtain a Texas Private Investigator license. + Self-motivated, determined, and intuitive. + Strong initiative and work… more
- Highmark Health (Austin, TX)
- …Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment ... methodology, claims processing systems and coding and billing proficiency + Must have understanding of technical and financial aspects of the health insurance… more
- Sedgwick (Fort Worth, TX)
- …Bachelor's degree from an accredited college or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI), ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for managing SIU investigations… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …late-breaking clinical trial sessions + Sponsored symposia and educational sessions + Investigator meetings and closed sessions + Booth design and scientific content ... before, during, and after congresses + Organize and facilitate investigator meetings and advisory boards in conjunction with congresses...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …of clinical facility and system audits at all relevant facilities, investigator sites, and vendors (including contract research organizations) and ensure that ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …Otsuka's clinical trials program, including registrational, post-marketing and Investigator -Sponsored Trials (ISTs), health economic outcomes research, other ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …pharmacology** sections for regulatory filings, including annual reports, investigator 's brochure, IND/NDA/BLA applications and pediatrics development plans in ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Prime Therapeutics (Austin, TX)
- …and client initiatives; engage in cross functional analysis of medical and pharmacy claims ; lead FWA investigations for federal employee program + Stay current on ... situations + Knowledge and understanding of pharmacy or medical claims processing environment **Preferred Qualifications** + Certified Fraud Examiner or… more