- 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 ... addition to Level I Accountabilities) + Performs more complex investigations with less direct supervision. Performs compliance and/or governance...criminal justice or related field; or employment as an investigator in the SIU on or before… more
- Blue KC (Kansas City, MO)
- …**Job Description Summary:** As part of Blue KC's Special Investigations Unit ( SIU ), the Fraud Investigator conducts reviews to identify potential ... policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations . +...Healthcare Fraud Investigator (AHFI) + Medical License: Registered Nurse ( RN ), Licensed Practical… more
- MVP Health Care (Rochester, NY)
- …limited to MD or RN . + New York State Nursing license required ( RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC ... improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for...if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication… more
- Molina Healthcare (Milwaukee, WI)
- …Microsoft Excel (edit/save spreadsheets, sort/filter) **Required License, Certification, Association** Licensed registered nurse ( RN ), Licensed practical ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for...5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge… more