- Usaa (Parkersburg, WV)
- …What sets you apart: SIU experience conducting low to complex PNC fraud investigations OR a combination of Claims and Law Enforcement Investigations OR ... and impactful. The Opportunity We are looking for a SIU Investigator (mid-level). This is a desk...School Diploma or General Equivalency Diploma (GED). 2+ years claims adjusting experience, or P&C SIU /Fraud Investigation… more
- Allied Universal (Billings, MT)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... a difference. Allied Universal(R) is hiring a Surveillance / Claims Investigator . Surveillance / Claims ...of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims… more
- Command Investigations (San Diego, CA)
- CLAIMS INVESTIGATOR Seeking an experienced investigator with multi-lines investigations to include W/C and P&C experience. SIU experience is also ... website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the...proficiency in the following areas: + W/C and P&C investigations + Writing accurate, detailed reports + Strong initiative,… more
- Command Investigations (Brooklyn, 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, ... with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We...Auto, or Homeowners Investigations . + Writing accurate, detailed reports + Strong initiative,… more
- Command Investigations (TN)
- …hire. Visit our website and find out why at www.GoCommand.com . The Claims /Surveillance Investigator should demonstrate proficiency in the following areas: + ... 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
- 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
- UPMC (Pittsburgh, PA)
- …is a remote position. Under the direction of the manager, the Special Investigations Unit ( SIU ) Investigator is responsible for investigating ... UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator...supporting current SIU staff and manager with investigations and special projects. Responsibilities: + Maintain… more
- Allied Universal (Winchester, VA)
- … Unit ( SIU ) Investigator . Special Investigations Unit ( SIU ) Specialists investigate claims with red flags that suggest fraudulent behavior ... five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims +...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- Kemper (Doral, FL)
- …claims referred to and accepted for investigation by the Special Investigative Unit . Our Special Investigator will function as a remote ... Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department...agencies as required by law and management. Keeps the Special Investigation Unit and field managers advised… more
- USAA (San Antonio, TX)
- …presentation skillset. + SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement Investigations ... and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). **This is a "Desk"...Diploma or General Equivalency Diploma (GED). + 2+ years claims adjusting experience, or P&C SIU /Fraud Investigation… more
- Centene Corporation (Frankfort, KY)
- …Position acts as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud, Waste and Abuse of Medicaid services within Kentucky. Provides ... + Manage and coordinate cases being investigated by the SIU + Maintain all vendor cases + Assist with...Maintain all vendor cases + Assist with conducting complex investigations , including on-site investigations , review, complete and… more
- Command Investigations (Baltimore, MD)
- Seeking experienced Claims / SIU and/or Workers' Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and ... 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 (Seattle, WA)
- …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 -...investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines… more
- CVS Health (Columbus, OH)
- …do it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected ... fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business +...in identifying resources and best course of action on investigations + Serves as back up to the manager… more
- Philadelphia Insurance Companies (Ewing, NJ)
- …: Review and evaluation of claims and applications referred to the SIU for possible fraud. Conduct database investigations , including use of CLEAR, ISO ... by AM Best. We are looking for a Sr. Claims Examiner - SIU to join our...for thoroughness and accuracy. Review and evaluation of completed SIU investigations for referral to state authorities,… 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 ... investigations and audits; or five years of insurance claims investigation experience or professional investigation experience with law...criminal justice or related field; or employment as an investigator in the SIU on or before… 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 join the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving providers who submit … more
- Command Investigations (Detroit, MI)
- …) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator . SuperiorX Investigations ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- MVP Health Care (Tarrytown, 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...related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation… more
- Point32Health (Canton, MA)
- …an essential team member of the Special Investigation Unit (" SIU ") responsible for leading complex provider investigations related to fraud, waste, and ... **Job Summary** The Investigator I is...for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the Manager, FWA Prepayment… more
