- The Robison Group (Brooklyn, NY)
- …opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU Investigator , you will be joining an incredible team ... are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire… more
- Providence (Oakland, CA)
- **Description** ** Investigator External Audit Special Investigations Unit \*Remote The SIU Audit Investigator supports the compliance related ... activities of the Special Investigations Unit ( SIU ) at the...Qualifications:** + Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. + Certification as an Internal… more
- Humana (Indianapolis, IN)
- …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 ... Integrity (OMPP PI) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities to increase Medicaid program… more
- Allied Universal (Chesapeake, VA)
- …the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator . Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… more
- Capital One (Mclean, VA)
- AML Sr Investigator II- SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized ... (SME)** will work closely with key stakeholders in the SIU and outside of the SIU when...+ Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in… more
- Capital One (Mclean, VA)
- AML Senior Investigator II- SIU **The Anti-Money Laundering (AML) Supervisor** **supervises various AML processes, which might include suspicious activity ... investigations , closing reviews, or other AML processes. The associate...managing the workflow of the AML analysis. The AML Investigator II coaches their team and teaches others about… more
- Command Investigations (Orlando, FL)
- Seeking a full-time experienced SIU /Insurance investigator . A minimum of 3 years' experience as an insurance Investigator is required. Must have background ... in handling multi-lines investigations and some SIU experience. Must have...a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the… more
- Command Investigations (Chicago, IL)
- Seeking an experienced SIU /Insurance investigator to cover Chicago, IL and its surrounding areas. Candidates must reside within 60 miles of Chicago. A minimum of ... staff. This is a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the following areas: +… more
- Command Investigations (Ventura County, CA)
- Experienced SIU Investigator A minimum of 5 years' SIU experience is required. Must have background in handling P&C investigations . Candidates who do not ... and staff. This is a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the following areas: + P&C… more
- Command Investigations (San Diego, CA)
- SIU INVESTIGATOR A minimum of 5...is required. Must have experience in Commercial and P&C investigations . * Candidates who do not have property (non-auto) ... a W-2 role; subcontractors will not be considered. The SIU Investigator should demonstrate proficiency in the...should demonstrate proficiency in the following areas: + P&C investigations , with all lines preferred. + Writing accurate and… more
- Command Investigations (Baltimore, MD)
- …Claims/ SIU and/or Workers' Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and Industrial/workplace accidents. ... and staff. Must have a background in handling multi-lines investigations with personal lines highly desired. Must have reliable...our website and find out why at www.GoCommand.com. The SIU /WC Investigator should demonstrate proficiency in the… more
- Elevance Health (Chicago, IL)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU ** **Location:** This role requires associates to be in-office 1 - 2… more
- CVS Health (Charleston, WV)
- …every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known ... in identifying resources and best course of action on investigations + Serves as back up to the Team...years of working health care fraud, waste and abuse investigations ). **Anticipated Weekly Hours** 40 **Time Type** Full time… more
- CVS Health (OK)
- …of Oklahoma. Must be willing to work CDT schedule. - Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud ... to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. -… more
- Centene Corporation (Frankfort, KY)
- …of healthcare fraud and abuse activity. Assist in planning, organizing, and executing special claims investigations or audits that identify, evaluate and measure ... parties to obtain refund + Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or… more
- Centene Corporation (Sacramento, CA)
- …and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud ... and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document...referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as… more
- Allied Universal (Raleigh, NC)
- …and investigations with a carrier, third-party administrator and/or vendor contracted special investigations unit , plus one year conducting complex ... desired - 4 years of sustained performance as an investigator , police officer, or military investigations may...skills to include Word, Excel, PowerPoint, and Outlook + Special Investigative Unit ( SIU ) Compliance… more
- Molina Healthcare (Nampa, ID)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and...assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall ... addition to Level I Accountabilities) + Performs more complex investigations with less direct supervision. Performs compliance and/or governance...criminal justice or related field; or employment as an investigator in the SIU on or before… more
- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication...involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more