- Dexian - DISYS (Baltimore, MD)
- …may include performance of audits of financial business records, provider and subscriber medical data, claims , systems reports, medical records, analysis of ... for offsite audits/investigations and interviews when requested. Research provider/subscriber claims activity, operations manuals, data systems, medical … more
- nTech Solutions, Inc. (Baltimore, MD)
- …may include performance of audits of financial business records, provider and subscriber medical data, claims , systems' reports, medical records, analysis of ... for offsite audits/investigations and interviews when requested. Research provider/subscriber claims activity, operations manuals, data systems, medical … more
- Allied Universal (Beckley, WV)
- …for most full-time compliance and investigation jobs! Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for ... in our communities and customers we serve. We offer medical , dental and vision coverage, life insurance, retirement plan,...Insurance claims through scene Investigations, claimant and witness Interviews, document… more
- MTA (Brooklyn, NY)
- Claims Fraud Investigator (Special Investigations) Job ID: 7127 Business Unit: MABSTOA Location: Brooklyn, NY, United States Regular/Temporary: Regular ... with enforcement agencies, insurance carriers and organizations dedicated to combating claims fraud. Education and Experience Claim Fraud Investigator +… more
- Allied Universal (Pittsburgh, PA)
- …compliance and investigation jobs! Allied Universal(R) is hiring a SIU / Claims Investigator . Special Investigations Unit (SIU) Specialists investigate claims ... in our communities and customers we serve. We offer medical , dental and vision coverage, life insurance, retirement plan,...policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for… more
- JBS USA (Greeley, CO)
- **Deductions/ Claims Investigator ** **Purpose and Scope/General Summary:** We are looking for a Deductions/ Claims Investigator for our Fed Beef division. ... sit at our Corporate office in Greeley, CO. The Deductions/ Claims Investigator responds to notifications of discrepancies...following **compensation and benefits** : + **Benefits** : Vision, Medical , and Dental coverage begin after 60 days of… more
- State of Indiana (Fort Wayne, IN)
- Claims Investigator Date Posted: Apr 26, 2024 Requisition ID: 442419 Location: Fort Wayne, IN, US, 46805 Work for Indiana Begin a fulfilling career with the ... (3) years of comparable experience. + Successfully completed the Claims Investigator Trainee Program. + The ability...package for full-time employees which includes: + Three (3) medical plan options (including RX coverage) as well as… more
- Command Investigations (Raleigh, NC)
- …for hire. Visit our website and find out why at www.GoCommand.com. The Claims /Field Investigator should demonstrate proficiency in the following areas: + ... in Criminal Justice or similar + Bilingual candidates Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Extensive performance bonus program… more
- Command Investigations (Orlando, FL)
- …for hire. Visit our website and find out why at www.GoCommand.com. The Claims /Field Investigator should demonstrate proficiency in the following areas: + Writing ... Degree in Criminal Justice or similar + Bilingual candidates Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Dynamic and fast paced work… more
- The Hartford (NJ)
- SIU Investigator - CF08BE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here ... our team as we help shape the future. We are seeking a talented Special Investigator to join our Special Investigations Unit (SIU). This position will be based out… more
- Commonwealth of Pennsylvania (PA)
- …+ Credits/Clock Hours 10 WORK BEHAVIOR 2 - INVESTIGATES PERSONAL INJURY CLAIMS AND THEIR ESTATES Investigates medical assistance recipients' personal injury ... Performance" which best describes your claim. + A. I have experience investigating medical assistance recipients' personal injury claims AND their estates by… more
- State of Georgia (Fulton County, GA)
- …AND two (2) years of clinical experience AND one (1) year experience working with medical claims . Preference will be given to applicants who hold a Bachelor's of ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only) Hot...experience; additional years of experience in the analysis of medical claims and/or claims data;… more
- EFI Global (Chantilly, VA)
- …certification requirements.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, ... large fire loss, and multiple claims .** **Ensures that assigned cases are investigated and reported back to the requesting party in adherence to best practices.… more
- SGI Global, LLC (Raleigh, NC)
- …complicated and highly technical, regulatory, and/or scientific data and documents, including medical records, medical claims data, prescription data, ... SGI Global is seeking a Civil Investigator (Healthcare Fraud and Opioid Matters) to support...interviews, and prepares associated reports. + Gathers and examines medical records, pharmaceutical records, claims data, prescription… more
- National General Insurance Company (Uniondale, NY)
- ** This role is a field Investigator role where the investigator would travel within a territory of Essex county, Union County and Bergen county, NJ AND the 5 ... Manhattan, Brooklyn, The Bronx, Queens and Staten Island NY. Previous SIU claims and/or law enforcement investigation experience preferred** Job Summary: This job is… more
- Elevance Health (Columbus, OH)
- …Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical -expense spending. The **Senior Investigator ** is responsible for the ... **Senior Investigator ( Investigator Sr)** _Location: This position...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Customs and Border Protection (Washington, DC)
- …collusion, conspiracy, forgery, bribery, embezzlement, theft, Procurement Integrity Act, False Claims Act, and fraud. Leading and conducting sensitive and complex ... review the following links: Background investigation and the e-QIP process. Medical Examination: Individuals must meet the established medical standards… more
- Molina Healthcare (Omaha, NE)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and...may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to… more
- Elevance Health (Columbus, OH)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Investigator Senior** is responsible for the ... ** Investigator Senior** **Supports the Payment Integrity line of...to recover corporate and client funds paid on fraudulent claims . **How will you make an impact:** + Claim… more
- Allied Universal (Coventry, RI)
- …will reflect in our communities and customers we serve. We offer medical , dental and vision coverage, life insurance, retirement plan, employee assistance programs, ... and investigation jobs! Allied Universal(R) is hiring a Surveillance Investigator . Surveillance Investigators perform discreet mobile and stationary surveillance of… more
