- 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
- 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 (San Antonio, 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)
- **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... and adaptable workplace. Alternate locations may be considered. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that may… 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
- Elevance Health (Houston, 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
- Allied Universal (Fort Worth, 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
- Molina Healthcare (San Antonio, 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
- 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
- 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
- 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
- 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
- Texas A&M University System (Texarkana, TX)
- …Act and FMLA. Responds to unemployment insurance and worker's compensation claims . + Implements the performance improvement process by diagnosing employee competency ... and work cooperatively with others. + Ability to obtain and maintain investigator certification + Knowledge of Microsoft Office applications, including Word, Excel,… more