- CVS Health (Oklahoma City, 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
- Providence (Oakland, CA)
- …** Investigator External Audit Special Investigations Unit \* Remote The SIU Audit Investigator supports the compliance related activities of ... the Special Investigations Unit ( SIU ) at the...we must empower them. **_Providence Health Plan welcomes 100% remote work for applicants who reside in the following… more
- The Robison Group (Brooklyn, NY)
- …reading and speaking Spanish. 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
- Molina Healthcare (Milwaukee, WI)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including Microsoft Word (edit/save… more
- USAA (Baton Rouge, LA)
- …makes us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). **This is a field position.** A company car is ... and regulations and policies and procedures. **This role is remote eligible. However,** **you need to live in the...SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement… 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
- Molina Healthcare (Louisville, KY)
- **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
- 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
- AmeriHealth Caritas (Columbus, OH)
- … investigations . + Performs necessary functions to support all aspects of SIU investigations and responsibilities to include, but not limited to: Intake; ... Special Investigation Units and fraud, waste and abuse investigations . + Conducts investigations of potential; fraud,...in lieu of formal educational requirements for the Lead SIU Investigator position may be considered.; +… more
- The Robison Group (Albany, NY)
- Individuals selected for the position will be expected to perform investigations of workers compensation claims, liability investigations , multi-line insurance ... We are looking for people who are enthusiastic about investigations , those who thrive in a diverse work environment,...willing and able to obtain a New York Private Investigator license. + Self-motivated, determined, and intuitive. + Strong… more
- Command Investigations (TN)
- Command Investigations LLC is a dynamic and forward-thinking investigative company that has been at the forefront of the industry since its establishment in ... as a leader in the investigation industry. At Command Investigations , we take pride in our proven track record...with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required, as… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The Special Investigations Unit ( SIU ) Investigator is responsible to conduct timely and thorough health care fraud ... investigations on behalf of the Company. Investigations ... are confidential and are conducted in accordance with SIU Policies and Procedures, contractual obligation and in accordance… more