- Collins Aerospace (Atlanta, GA)
- …corrective actions for technical issues at the Atlanta Service Center, perform special investigations , and product testing. Other duties might include ... paid time off, and holidays. Specific benefits are dependent upon the specific business unit as well as whether or not the position is covered by a… more
- Allied Universal (Framingham, MA)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator. Special ... ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor **QUALIFICATIONS (MUST HAVE):** + Must… more
- The Hartford (Los Angeles, CA)
- …the future. We are seeking a talented Special Investigator to join our Special Investigations Unit (SIU). This position will cover Los Angeles County. ... which will assist in the adjudication of the claim. The mission of the Special Investigations Unit (SIU) is to contribute to claims accuracy by building… more
- The Robison Group (Sarasota, FL)
- …other investigative tasks. This is a remote opportunity for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator, you will ... 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
- CVS Health (Columbus, OH)
- …triage of incoming healthcare fraud, waste, and abuse referrals/leads received in the Special Investigations Unit (SIU) from various internal and external ... sources. * Runs initial Case Set Up reports, and gathers additional information relevant to the case * Documents the receipt of new incoming referrals/leads for tracking purposes and prepares referrals for transfer to either Level 2 Triage or to Investigative… more
- CVS Health (Columbus, OH)
- …each and every day. **Position Summary** The SIU Investigator conducts investigations to effectively pursue the prevention, investigation and prosecution of ... in identifying resources and best course of action on investigations . - Cooperates with federal, state, and local law...experience working on health care fraud, waste, and abuse investigations and audits required or equivalent investigations … more
- CVS Health (Hartford, CT)
- …It's a new day in healthcare! + Looking for opportunities to use cutting edge technologies analyzing petabytes of data on Google Cloud Platform? + Interested in ... generating analytical insights that inform provider networks and engagement strategies that support members on their individualized health and wellness journey? CVS's Analytics & Behavior Change team delivers strategically impactful programs and tools that… more
- Capital One (Mclean, VA)
- …closely with AML Supervisors and Managers to perform other critical functions. The Special Investigations Unit conducts suspicious activity reporting and ... AML Sr. Investigator I - Proactive Investigations **The Anti-Money Laundering (AML) Sr. Investigator I**...I** supports various AML processes, which includes suspicious activity investigations or other AML processes. The AML Sr. Investigator… more
- CVS Health (Columbus, OH)
- …convenient and more compassionate. And we do it all with heart, each and every day. The Special Investigations Unit is seeking a Manager to lead our team of ... Certified Professional Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation, and prevention efforts to safeguard the organization's resources and reduce healthcare costs. This role involves… more
- Command Investigations (Detroit, MI)
- … Investigations ) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator. SuperiorX ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- RELX INC (Alexandria, VA)
- …the link below. https://risk.lexisnexis.com/government About our Team The LexisNexis(R) Public Safety Special Investigations Unit is comprised of former ... subject matter expert on LexisNexis and Accurint TraX (ZetX) solutions within the Special Investigations Unit (SIU). The Public Safety SIU is comprised of… more
- Centene Corporation (Harrisburg, PA)
- …Position acts as a subject matter expert in the field of Compliance and/or Special Investigations Unit (SIU) investigations . Provides direction and ... while meeting all regulatory, CMS, and WellCare Corporate guidelines in which special care is required to protect and enhance WellCare's reputation. + Works… more
- Prime Therapeutics (Columbus, OH)
- …of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations Unit (SIU) teams. **Responsibilities** + Perform and ... and/or coordination with an external collection agency + Evaluate audits, investigations and/or claims identified for potential recoupment to verify that results… more
- Elevance Health (Norfolk, VA)
- …**INVESTIGATOR LEAD** is responsible for providing leadership and guidance to the Special Investigations Unit team in investigating, collecting, researching ... manager with the administration and operational activities occurring within the Special Investigations Unit for Pharmacy investigations ; coordinating and… more
- M. C. Dean (Vienna, VA)
- …coverage; review the established reserve requirements, identified claims for subrogation and/or Special Investigations Unit as appropriate. + Assesses actual ... regulatory issues and available resources. + Plans and conducts investigations of claims to confirm coverage and to determine...Knowledge and abilities of Microsoft suite of applications with special emphasis on excel and the ability to pivot… more
- Travelers Insurance Company (Winston Salem, NC)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- Travelers Insurance Company (Sacramento, CA)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... party property content claims with moderate to high severity, ie Major Case Unit losses. + Occasionally handles 1st party property claims of moderate complexity as… more
- Travelers Insurance Company (Winston Salem, NC)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- USAA (Boston, MA)
- …and 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
- CVS Health (Franklin, TN)
- …Escalates suspicious billing behavior or inconsistent patterns to management or the Special Investigations Unit (SIU), providing supporting documentation and ... analysis. * Monitors claim trends and highlight FWA risks related to Med Supp processing. * Identifies system and process improvements in workflows to enhance accuracy, timeliness, and fraud prevention. * Provides mentorship and technical guidance to junior… more
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