- The Travelers Indemnity Company (Washington, DC)
- …internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . ... Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including… more
- The Travelers Indemnity Company (Glendale, CA)
- …internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . ... Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including… more
- PMA Companies (Fort Lauderdale, FL)
- …for subrogation recovery, and second injury fund (when applicable) Alert Supervisor and Special Investigations Unit to potentially suspect claims Ensure ... timely denial or payment of benefits in accordance with jurisdictional requirements Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure Negotiate claims settlements… more
- Summa Health (Akron, OH)
- RN Special Investigations Unit ( SIU ) Investigator SummaCare - 1200 E Market St, Akron, OH Full-Time / 40 hours / Days Hybrid / Remote SummaCare is a ... medical records c. Accredited Healthcare Fraud Investigator (AHFI) certification preferred. d. Special Investigations Unit ( SIU ) experience in a managed… more
- CVS Health (Sacramento, CA)
- …and more compassionate. And we do it all with heart, each and every day. Medical Director - SIU ( Special Investigations Unit ) CVS Health - Special ... **This is a remote based, work from home role.** Key Responsibilities: The Special Investigations Unit ( SIU ) Medical Director will be responsible for… more
- JPMorgan Chase (Jersey City, NJ)
- …security solutions, ensuring a safer and more secure future for all. As a Special Investigations Unit Investigator within the Global Security team, you ... will be responsible for conducting complex and sensitive investigations involving Code of Conduct violations in both North America and Latin America and coordinate… more
- CVS Health (Columbus, OH)
- …with heart, each and every day. Come work for Aetna Better Health of Illinois and the Special Investigations Unit ( SIU )! **Position Summary** The SIU ... in identifying resources and best course of action on investigations . - Cooperates with federal, state, and local law...experience working on health care fraud, waste, and abuse investigations and audits required or equivalent investigations … more
- The Robison Group (Carbondale, IL)
- …searches, and other investigative tasks. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... 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
- McLaren Health Care (Flint, MI)
- …programs. Learn more about MDwise, Inc. at https://www.mdwise.org/ . **Position Overview:** The Special Investigations Unit ( SIU ) Coder supports lines ... We are looking for a SIU Coder, to join us in leading our...performing medical claims and records reviews to assist in investigations , ensuring compliance with coding practices through a comprehensive… more
- CVS Health (Oklahoma City, OK)
- …with medical record review within a healthcare insurance company. - Prior special investigation unit experience. - Excellent analytical skills. - Excellent ... communication skills. **Education** - GED or equivalent - AAPC Certified Professional Coder Certification (CPC) **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $43,888.00 - $102,081.00 This pay… more
- Corewell Health (Grand Rapids, MI)
- …SITE - Priority Health - 1231 E Beltline - Grand Rapids Department Name PH - Special Investigations Unit Employment Type Full time Shift Day (United States ... Job Summary - Manager Special Investigation Unit The SIU...organization + Direct and oversee a broad range of investigations and audits related to FWA, including medical and… more
- Corewell Health (Grand Rapids, MI)
- …SITE - Priority Health - 1231 E Beltline - Grand Rapids Department Name PH - Special Investigations Unit Employment Type Full time Shift Day (United States ... of America) Weekly Scheduled Hours 40 Hours of Work 8:00 am to 5:00 pm Days Worked Monday to Friday Weekend Frequency N/A CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for… more
- Allied Universal (Salt Lake City, UT)
- …**Private Investigator's license** **required** **prior to applying** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. ... Special Investigations Unit ( SIU ) Specialists investigate claims with red flags that suggest...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- CVS Health (Hartford, CT)
- …are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ). In this role, you will manage ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.… more
- Capital One (Mclean, VA)
- AML Sr Investigator II- SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized investigations ... (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
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Senior Investigator is to assist in the reduction and ... projects as assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education Level:** Bachelor's Degree… more
- Command Investigations (Detroit, MI)
- … Investigations ) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator. SuperiorX ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- US Bank (Tempe, AZ)
- …skills and discover what you excel at-all from Day One. **Job Description** US Bank's Special Investigations Unit ( SIU ) is seeking an investigative ... for its Emerging Risk and Trends (ERT) Team. The SIU is part of US Bank's Enterprise Financial Crimes...This role reports directly to the Director of the Special Investigations Unit to ensure… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to ... the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving...and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities… more
- City of La Mesa, CA (La Mesa, CA)
- …patrol, field training officer, investigations , motor officer, school resource officer, special investigations unit , street team, honor guard and the ... and local traffic regulations; participates in and conducts a variety of criminal investigations ; provides support and assistance to special crime prevention and… more
