- The Hartford (Hartford, CT)
- …with proactive execution abilities. Specific qualifications include:* 8+ years Property Casualty SIU insurance fraud leadership experience at a national ... President Claim Solutions who has oversight of The Hartford's SIU Anti- Fraud Programs, the AVP SIU...focused industry associations and law enforcement agencies engaged in insurance fraud detection, deterrence and mitigation strategies.*… more
- Allied Universal (Atlanta, GA)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud ...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- The Hartford (Los Angeles, CA)
- …shape the future. We are seeking a talented Special Investigator to join our Special Investigations Unit ( SIU ). This position will cover Los Angeles ... the adjudication of the claim. The mission of the Special Investigations Unit ( SIU...understanding of investigative techniques and the laws pertaining to insurance claims and mandated fraud reporting as… more
- Providence (Beaverton, OR)
- **Description** **Investigator External Audit Special Investigations Unit ( SIU )** **_Remote._** The SIU Audit Investigator supports the compliance ... related activities of the Special Investigations Unit ( SIU...Coding experience with a healthcare provider, facility or health insurance company. + 2 years - Fraud … more
- USAA (Los Angeles, CA)
- …claims by investigating questionable, suspect claims activity in compliance with state insurance fraud -related laws and regulations and policies and procedures. ... Apply knowledge of state laws and regulations pertaining to insurance fraud in investigating claims. + Collect...include Auto, Property and Underwriting + Current or prior SIU investigations experience working in diverse teams… more
- Travelers Insurance Company (St. Paul, MN)
- …obtain assistance in conducting investigations . + Identifies cases for potential insurance fraud prosecution and submits questionable claims to the National ... into actionable investigative strategies including the identification of complex case investigations . + Conducts insurance investigations including… more
- Kemper (Lake Mary, FL)
- …**POSITION SUMMARY** : The SIU Manager will manage a staff of SIU Investigators conducting field and desk investigations for Kemper Companies. This position ... : + Conducts interviews and aids in selection and training/development of SIU personnel. + Provides oversight of all investigations assigned within… more
- Kemper (Henderson, NV)
- …by law and management. + Responsible for communicating critical situations to the Special Investigation Unit and field managers. + Develops and maintains ... that delivers on our promises._ **Position Summary** : The SIU Desk Investigator I is responsible for the investigation...contacts with other Special Investigative Units and fraud related organizations.… more
- CVS Health (Harrisburg, PA)
- …highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This role is ideal ... healthcare datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud , waste, and abuse in Medicaid claims and… more
- Sedgwick (Fort Worth, TX)
- … Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for managing SIU investigations of complex fraud schemes involving providers, vendors, ... preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI), or Certified ...to five (5) years of supervisory experience handling complex fraud investigations , or equivalent combination of education… more
- Allied Universal (Butte, MT)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims +...+ Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud… more
- Humana (Baton Rouge, LA)
- …a part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Fraud and Waste Investigator to join the ... Strong clinical experience to include multiple practice areas + 2+ years of fraud investigations and auditing experience + Knowledge of healthcare payment… more
- RELX INC (Washington, DC)
- …informed decisions to enhance investigations . About the Team: The Public Safety Special Investigative Unit ( SIU ) is comprised of former law enforcement ... real-time investigative insight for LexisNexis customers. The Public Safety SIU also serves to work with the sales team...of call detail record data provided by the customer, fraud investigations , etc Requirements: + Bachelor's or… more
- Command Investigations (FL)
- …possible, setting the bar high for investigative excellence. Seeking experienced Insurance Fraud Investigators with commercial or personal lines experience, ... Command Investigations LLC is a dynamic and forward-thinking investigative...with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required, as… more
- USAA (Tampa, FL)
- …medical claims, and provide expert advice. Conducts review of complex healthcare fraud investigations and providing claims support + Medical Coding Proficiency: ... risk assessment rules. + Guides and trains claim and special investigation unit investigators and aids in...fraud waste and abuse. + Advises claims and SIU investigators on the proper risk assessment of … more
- NJM Insurance (Trenton, NJ)
- … fraud and promptly notify the supervisor if a case warrants investigation by the Special Investigations Unit ( SIU ). + Prepare and issue monthly audit ... assignments for NJM auditors and independent audit vendors. Include relevant policy information and instructions as required to ensure efficient audit processing. + Identify and process estimated audits for policyholders who are noncompliant with mail audit… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …(eg APS/CPS) as needed, and any suspected/possible Medicaid fraud to the Special Investigations Unit ( SIU ) or designated internal/external entity.* ... the total rewards package may include participation in group health and/or dental insurance , retirement plan, wellness program, paid time away from work, and paid… more
- Prime Therapeutics (Lansing, MI)
- …of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations Unit ( SIU ) teams. **Responsibilities** + Perform ... is responsible for recovering inappropriate pharmacy payments related billing errors and fraud , waste and abuse (FWA) through various mechanisms, including but not… more
- Travelers Insurance Company (Hartford, CT)
- …+ Determine cases that may have fraud potential and to refer claims to Special Investigations Unit . + In order to perform the essential functions of ... this job, acquisition and maintenance of Insurance License(s) may be required to comply with state...required **What Is in It for You?** + **Health Insurance ** : Employees and their eligible family members -… more
- USAA (Tampa, FL)
- …policy provisions. + Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable. + Maintains ... treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Senior Auto Appraiser, within defined… more