- Allied Universal (Louisville, KY)
- …+ **Paid Time Off and Paid Holidays (FT only)** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud ...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- CVS Health (Oklahoma City, OK)
- …medical record review within a healthcare insurance company. - Prior special investigation unit experience. - Excellent analytical skills. - Excellent ... state and federal policies. - Identify potential billing errors, abuse, and fraud . - Identify opportunities for savings related to potential cases which may… more
- American Family Insurance - Corporate (Seattle, WA)
- … activity involving property claims, develop meaningful industry social network and assist special investigations leadership in promoting fraud awareness and ... partners, agents and customers. You will report to a Special Investigations Manager. In this primarily home-based...+ Communicate with internal and external business partners regarding investigations and insurance fraud matters.… more
- Travelers Insurance Company (Downers Grove, IL)
- …in or near the Chicago, IL area **What Will You Do?** + Conducts insurance investigations including applicable data base searches with a focus on uncovering ... of applicable law and local office expectations. + Identifies cases for potential insurance fraud prosecution and submits questionable claims to the National … more
- Elevance Health (Gilbert, MN)
- …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 - Calrelon Payment Integrity SIU ** **Location:** This role requires associates to be in-office 1 - 2… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Senior Investigator is to assist in the reduction and ... State/Federal criminal statutes and criminal and civil law impacting insurance fraud /abuse investigations to preserve...assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education… more
- Prime Therapeutics (Des Moines, IA)
- …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... and drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the...visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations /claims experience. + Ability to manage… more
- Corewell Health (Grand Rapids, MI)
- …SITE - Priority Health - 1231 E Beltline - Grand Rapids Department Name PH - Special Investigations Unit Employment Type Full time Shift Day (United States ... Job Summary - Manager Special Investigation Unit The SIU...with a focus on identifying, investigating, and resolving health insurance fraud , waste, and abuse (FWA). This… more
- Kemper (Henderson, NV)
- …by law and management. + Responsible for communicating critical situations to the Special Investigation Unit and field managers. + Develops and maintains ... that delivers on our promises._ **Position Summary** : The SIU Desk Investigator I is responsible for the investigation...contacts with other Special Investigative Units and fraud related organizations.… more
- Elevance Health (Atlanta, GA)
- **Investigator II - Payment Integrity SIU ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent… more
- Centene Corporation (Sacramento, CA)
- … investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste, abuse, and ... fraud + Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and...referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as… 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+ ... of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims +...+ Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud… more
- Kemper (Lake Mary, FL)
- … + Completion of the NICB Basic and/or Analytics Academies are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or ... Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designations are +… more
- CNO Financial Group (Carmel, IN)
- …skills and location. **CNO Financial Group** is hiring a **Business Analyst Corporate Investigations and Support** to work Fraud , Waste, and Abuse (FWA) ... CNO systems for research and analysis. **What you'll need:** + Associate's Degree in Fraud Risk, Insurance , Financial Services, or four years of relevant work… 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 ... $62,100.00 - $111,800.00 **Skills** Depositions, Evidence Collection, Forensic Accounting, Fraud Investigations , Investigation Techniques, Investigative Analysis, Job… more
- Command Investigations (FL)
- …possible, setting the bar high for investigative excellence. Seeking experienced Insurance Fraud Investigators with commercial or personal lines experience, ... 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
- USAA (San Diego, CA)
- …policy provisions. + Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable. + Maintains ... we treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Sr. Field Auto Appraiser, you will… more
- Command Investigations (Detroit, MI)
- … Investigations ) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator. SuperiorX ... for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud , one case at a time.… more
- Highmark Health (Albany, NY)
- …provides supporting documentation. *Identifies potential fraud cases and forwards to Special Investigations Unit . E3. Adjusts claims: *Performs online ... providers, internal and external customers; Adjusts claims. This is a bargaining unit position. The collective bargaining agreement for this position requires that… more
- NJM Insurance (Trenton, NJ)
- …injured workers, medical providers, the NJM Medical Claims Services Department, the NJM Special Investigation Unit , the NJM WC Legal Staff, and other departments ... delivery of timely, appropriate, and accurate benefits + Evaluate the claim for potential fraud indicators and escalates the file to SIU , as appropriate +… more