- Synectics Inc (Milwaukee, WI)
- …independently while handling claims , may work with or consult with Sr. Claims Adjuster and Investigator . Works with insurance, legal and other industry ... field complaint handling. Bachelor's in Engineering, Risk Management, Insurance, or Law preferred Must have insurance and claims experience. Attention to detail… more
- Command Investigations (Long Island City, NY)
- …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, ... experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly… more
- The Travelers Indemnity Company (Diamond Bar, CA)
- …identify risk and combat fraudulent practices at scale. As an SIU Specialized Investigator , you will lead complex, multi- claim investigations with regional and ... collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a… more
- NEW YORK POWER AUTHORITY (White Plains, NY)
- Summary The Senior Equal Employment Opportunity (EEO) Investigator is responsible for overseeing and conducting thorough investigations into complaints of ... harassment, and other EEO-related issues within the organization. The Investigator will also assist in facilitating reasonable accommodations for employees… more
- Los Angeles Metro (Los Angeles, CA)
- …these PQs will not automatically be selected. The following are the preferred qualifications: Experience leading staff specializing in claims analysis, ... live, work, and play within LA County. Description Supports Metro's Risk Claims Investigation administration as investigation leader by reviewing and analyzing … more
- Lemieux & Associates LLC (Seattle, WA)
- …surveillance as a private investigator is a must Experience conducting SIU/ Claims investigations is preferred but not required Bi-lingual is a plus ... excel. You must have surveillance experience as a Private Investigator , be licensed by the State of Washington as...licensed by the State of Washington as a Private Investigator and reside in the Seattle or surrounding area.… more
- FSA Federal (New York, NY)
- …to generate subpoenas, engage with potential defendants, and determine whether to pursue claims . The investigator will also lend support to our existing fraud ... of law enforcement and homeland security. We currently have a vacancy for a Civil Investigator . In this role, you will be supporting the overall mission of the US… more
- EFI Global, Inc. (Detroit, MI)
- …& Licensing Bachelor's degree from an accredited college or university preferred . IAAI Certified Fire Investigator (IAAI-CFI) certification or Certified ... buildings or residences. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Investigates assigned claims suspected of insurance fraud, this includes large loss, large… more
- Koalafi (Richmond, VA)
- …get what they need, while protecting the integrity of our platform. As a Risk Investigator , you'll be at the heart of that mission. You'll play a critical role ... or process changes to address them. Manage inbound fraud claims with professionalism and empathy, balancing customer care and...fraud trends demand Bonus: Fluency in Spanish is strongly preferred Why choose Koalafi: A career at Koalafi means… more
- Mount Sinai Hospital (New York, NY)
- …experience required. Familiarity with CPT and ICD (coding and CCI edits). Electronic claims processing preferred . About Us Strength through Unity and Inclusion ... Description Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner....payer and provider representatives to negotiate higher rates for claim payments. 6. Responds to patient and third party… more
- EFI Global, Inc. (Phoenix, AZ)
- …and RESPONSIBILITIES Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of the ... assignment. Determines the origin and cause of the loss/ claim under investigation and identifies any potential third-party responsibility for subrogation potential.… more
- Mount Sinai Hospital (New York, NY)
- …Interacts with these agencies to determine the effectiveness and accuracy of claim submission/processing in order to ensure all reimbursement forms and documentation ... seminars as required. Performs other related duties. Qualifications HS/GED. Bachelors degree preferred . 5 years of experience in a Patient Accounts with 2-3 years… more
- Mount Sinai Hospital (Elmhurst, NY)
- …information from the accounts receivable team to ensure the time processing of claims and all revenue is captured. Maintains daily logs of coded work. Assures ... with CPC / CCS-P credentials. At least six months coding experience preferred . Certified Professional Coder/AAPC. Ability to use computer. Average dexterity and… more
- University of Southern California (Los Angeles, CA)
- …lead programmer and technical specialist on research projects that use administrative healthcare claims data. SAS is required. The programmer is an integral part of ... the research team and works closely with the principal investigator and a multidisciplinary research team. The key role of the programmer is to develop a plan to… more
- Mount Sinai Hospital (New York, NY)
- …primarily responsible for receiving prescriptions, addressing and rectifying rejected claims , conducting and completing necessary third party (insurance) prior ... Responsibilities 1. Receives prescriptions, with appropriate follow up on rejected claims . 2. Completes third party prior authorization requests and verifies… more
- Mount Sinai Hospital (New York, NY)
- …and troubleshoot root causes, if/when needed. Assist with reviewing and maintaining claim edits and identify edit discrepancies based on coding guidelines and make ... training required by the coders. Qualifications Assoicate Degree. Bachelor?s Degree Preferred or equivalent working experience required. 5 years of directly related… more
- Mount Sinai Hospital (New York, NY)
- …Interaction with plan representatives regarding enrollment audits; problems and claims resolution; identify fee schedule issues; and addressing potential corrective ... care administration with general knowledge of Medical Staff Office functions. Preferred experience in health plan Provider Relations and/or Health Plan auditing… more
- Price Benowitz LLP (Washington, DC)
- …documentation required at different stages of pre-litigation. Coordinating with the Investigator to obtain photos of scene and witness statements when needed. ... Processing PIP/MedPay. Obtaining prior injury/medical and claims /lawsuits history and reviewing all medical records. Maintaining regular contact with clients.… more
- Kemper Corporation (Lake Mary, FL)
- …*College Degree or equivalent work experience *Three years of insurance claims experience or related fraud analytics background. Position Requirements: Strong ... Basic and/or Analytics Academies are desirable. Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA)… more
- Sedgwick (Salt Lake City, UT)
- …Marine Investigator **PRIMARY PURPOSE** **:** To perform detailed admiralty claims investigation and analysis through examination of the loss, collection of ... **Education & Licensing** Bachelor's degree from an accredited college or university preferred . Private investigator license preferred (40-hour course),… more
