- MVP Health Care (Rochester, 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...experience involving economic or insurance related matters. A clinical investigator must have in addition to the above requirements:… 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
- Capital One (Richmond, VA)
- AML Sr. Investigator I - Special Investigations Unit **AML Sr. Investigator I - Special Investigations Unit ** The Anti-Money Laundering ... investigations or other AML processes. The AML Sr Investigator I will work closely with AML Supervisors and...Supervisors and Managers to perform other critical functions. The Special Investigations Unit conducts suspicious… more
- Providence (Oakland, CA)
- **Description** ** Investigator External Audit Special Investigations Unit \*Remote The SIU Audit Investigator supports the compliance related ... activities of the Special Investigations Unit ( SIU ) at the...Qualifications:** + Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. + Certification as an Internal… more
- Allied Universal (Alexandria, LA)
- …the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator . Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… more
- Capital One (Mclean, VA)
- AML Sr Investigator II- SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized ... (SME)** will work closely with key stakeholders in the SIU and outside of the SIU when...+ Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in… more
- Command Investigations (NJ)
- Seeking a Full-Time experienced SIU /Insurance investigator to cover Los Angeles, CA. A minimum of 3 years' experience as an insurance Investigator is ... required. Must have background in handling multi-lines investigations and some SIU experience. Must have...Full Time role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the… more
- Command Investigations (Chicago, IL)
- Seeking an experienced SIU /Insurance investigator to cover Chicago, IL and its surrounding areas. Candidates must reside within 60 miles of Chicago. A minimum of ... staff. This is a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the following areas: +… more
- Command Investigations (Ventura County, CA)
- Experienced SIU Investigator A minimum of 5 years' SIU experience is required. Must have background in handling P&C investigations . Candidates who do not ... and staff. This is a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the following areas: + P&C… more
- Command Investigations (San Diego, CA)
- SIU INVESTIGATOR A minimum of 5...is required. Must have experience in Commercial and P&C investigations . * Candidates who do not have property (non-auto) ... a W-2 role; subcontractors will not be considered. The SIU Investigator should demonstrate proficiency in the...should demonstrate proficiency in the following areas: + P&C investigations , with all lines preferred. + Writing accurate and… 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 ... (GED). + 2+ years claims adjusting experience, or P&C SIU /Fraud Investigation experience OR 4+ years prior investigative law...SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement… more
- Command Investigations (Atlanta, GA)
- …Claims/ SIU and/or Workers' Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and Industrial/workplace accidents. ... 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
- U-Haul (Phoenix, AZ)
- …Strong Communication Skills + Claims knowledge Work Status: Full-time U-Haul offers its Special Investigation Unit : + Full Medical coverage + Prescription plans ... of fraudulent submissions. Work with the Regional Claims Manager and Regional SIU Manager to perform a variety of duties that require in-depth knowledge… more
- CVS Health (Nashville, TN)
- …every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known ... in identifying resources and best course of action on investigations + Serves as back up to the Team...years of working health care fraud, waste and abuse investigations ). **Anticipated Weekly Hours** 40 **Time Type** Full time… 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
- 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
- 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 ... of fraud, waste and abuse in accordance with SIU policies and procedures. May work with Manager and/or...policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations . +… more
- Point32Health (Canton, MA)
- … I is an essential team member of the Special Investigation Init ( SIU ( Special Investigations Unit )) responsible for leading complex provider ... The Investigator works closely with other members of the SIU to set investigative priorities, develop effective investigative strategies and techniques, and… 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
- 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
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