- Molina Healthcare (Savannah, GA)
- **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 (Cincinnati, 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 (Ann Arbor, MI)
- **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
- State of Michigan (MI)
- Corrections Investigative Officer 9-P11 (PREA Investigator ) Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4895797) Apply Corrections ... Investigative Officer 9-P11 (PREA Investigator ) Salary $25.85 - $40.51 Hourly Location Various, MI Job Type Permanent Full Time Job Number 4702-25-0014 AN… more
- State of Colorado (Denver, CO)
- …Justice Section is seeking an experienced investigator to join the Special Prosecutions Unit . In this role, you'll investigate allegations of criminal ... Special Prosecutions Investigator ( Special ...other crimes appropriate for investigation and prosecution by the Special Prosecutions Unit . As such, this position… more
- The Robison Group (Brooklyn, NY)
- …This is a remote opportunity for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible ... Qualified candidates are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and… more
- Humana (Dayton, 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
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Corrections and Community Supervision, Department of Title Investigator - Office of Special Investigations Occupational Category Enforcement or ... by the Assistant Deputy Chief Investigator and Deputy Chief Investigator . The minimum qualifications include two years' investigative , law enforcement,… more
- CVS Health (Topeka, KS)
- …are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a specific self-funded plan ... evidence in support of case investigations. **Required Qualifications** + 3-5 years investigative experience in the area of healthcare fraud, waste and abuse. +… more
- Louisiana Department of State Civil Service (LA)
- Investigator / Special Agent 1-4 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5143725) Apply Investigator / Special Agent 1-4 ... Justice, Office of Attorney General Liz Murrill, is seeking applications for an Investigator / Special Agent 1-4. As part of a Career Progression Group, vacancies… more
- Molina Healthcare (Louisville, KY)
- …the audit process and provide recommendations for system enhancement to augment investigative outcomes and performance. + Accurately tracks, reports, and follows up ... Association + Active and unrestricted Accredited Health Care Fraud Investigator (AHFI) designation or Certified Fraud Examiner (CFE) **Preferred Education**… more
- New York State Civil Service (Syracuse, NY)
- …NY Zip Code 13203 Duties Description Under the direction of a Senior Investigator , within the Compliance/Enforcement Unit , the position will conduct field visits ... / predicting likely outcome of contemplated actions; refining and improving investigative techniques.* Attend all agency/ unit -required meetings and training… more
- Humana (Tallahassee, FL)
- …of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Begins to influence department's strategy. Makes ... CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a corporate environment and… more
- Bureau of Alcohol, Tobacco, Firearms, and Explosives (Washington, DC)
- …Open Continuous Announcement (OCA) that will be used to fill multiple Criminal Investigator ( Special Agent) vacancies at the Washington Field Office. Eligible ... and conspiracy type violations of laws administered and enforced by ATF. As a Special Agent, your typical work assignments may include: Performs the full range of… more
- New York State Civil Service (Albany, NY)
- …No Agency Corrections and Community Supervision, Department of Title Senior Investigator - All Divisions Occupational Category Enforcement or Protective Services ... Salary Grade NS Bargaining Unit M/C - Managerial/Confidential (Unrepresented) Salary Range From $82543...Code 12226 Duties Description The NYS DOCCS Office of Special Investigations (OSI) is seeking qualified candidates for consideration… more
- State of Colorado (CO)
- CDOC - Criminal Investigator IV (Statewide) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5144627) Apply CDOC - Criminal Investigator IV ... Department of Corrections (CDOC). Through the use of systematic investigative techniques, position plans and conducts criminal and administrative investigations… more
- New York State Civil Service (Clinton, NY)
- …to DOCCS that is not covered by another OSI division. PID has two dedicated units, the Special Victims Unit (SVU) and Major Case Unit (MCU), to handle sexual ... and Community Supervision, Department of Title Assistant Deputy Chief Investigator - Public Integrity Division Occupational Category Enforcement or Protective… more
- City of New York (New York, NY)
- …or Task Force Officer, with a minimum of 1- 2 years experience in that special investigative assignment. - Flexibility for domestic or overseas travel. - Have ... Office (DANY) has an opening for a Senior Rackets Investigator in its Investigation Bureau. In this position, under...limited to: - Conducting, managing, and updating ongoing criminal investigative caseloads with a focus on, but not limited… more
- State of Michigan (MI)
- Corrections Investigative Officer 12 / Specialist 13 (PREA Investigative Specialist) Print ... Apply Corrections Investigative Officer 12 / Specialist 13 (PREA Investigative Specialist) Salary $29.92 - $47.75 Hourly Location Various, MI Job Type… more
- Point32Health (Canton, MA)
- …The Investigator I is an essential team member of the Special Investigation Unit ("SIU") responsible for leading complex provider investigations related ... and abuse, and developing action plans to address the investigative findings and prevent future loss. This role will...the direction of the Manager, FWA Prepayment Review. The Investigator I works closely with other members of the… more