- Premera Blue Cross (Mountlake Terrace, WA)
- …purposes. + Collaborate with internal teams (eg, claims processing, provider relations, special investigations unit ). + Utilize auditing software and ... communicate audit results and will collaborate with internal teams including the Special Investigation Unit and Payment Integrity Specialists. This role requires… more
- USAA (New York, NY)
- …us special and impactful. **The Opportunity** We are looking for a Manager, SIU ( Special Investigations Unit ) within P&C. Responsible for operational ... to mitigate fraud and other risks. + 4+ years of progressive experience within a Special Investigations Unit ( SIU ), with a proven track record in process… more
- Capital One (Richmond, VA)
- AML Sr. Investigator I - Special Investigations Unit **AML Sr. Investigator I - Special Investigations Unit ** The Anti-Money Laundering (AML) Sr. ... Supervisors and Managers to perform other critical functions. The Special Investigations Unit conducts suspicious...+ Self-manage a queue of alerts, cases, and closing investigations + Helps maintain operations of a SIU… more
- The Robison Group (Brooklyn, NY)
- …writing, reading and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... 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
- Elevance Health (Cleveland, OH)
- …recover, eliminate and prevent unnecessary medical-expense spending. **Staff Vice President (VP), Special Investigations Unit ( SIU )** **Location:** May ... teams across the national SIU . + Functions within the SIU include investigations , case intake and assignment, and data analysis. + Hires, trains, coaches,… 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 Health Plan. This role assists the External Audit Senior Manager with developing, implementing and… more
- City of New York (New York, NY)
- …and/or non-criminal, unique, highly confidential and sensitive investigations . The Special Investigation Unit ( SIU ) is responsible for investigating ... The New York City Department of Correction seeks to recruit Deputy Directors for the Special Investigation Unit ( SIU ). Under the direction of the Executive… more
- CVS Health (Washington, DC)
- …The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for ... medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company… more
- Centene Corporation (Jefferson City, MO)
- …and executing strategies that ensure high-quality, timely, value-generating FWA investigations in compliance with legal, regulatory, and contractual requirements. ... as external stakeholders, including law enforcement. + Lead and support enterprise-wide SIU team that detects, investigates, and mitigates FWA across all business… more
- Geisinger (Danville, PA)
- …Responsible for the strategic direction, planning, oversight, and operation of the Special Investigations ("SI") and Program Integrity ("PI") teams. Develops and ... by the enterprise. Job Duties + Provides leadership and strategic direction of Special Investigations and Program Integrity units spanning all lines of business.… more
- CVS Health (Phoenix, AZ)
- …parties including CVS Health corporate security, pharmacy audit and network teams, the client's special investigations unit ( SIU ), and Federal, State, ... we do it all with heart, each and every day. The Advisor- Investigations /Compliance provides expert healthcare fraud, waste, and abuse investigative expertise in… 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 investigations ... Investigations are confidential and are conducted in accordance with SIU Policies and Procedures, contractual obligation and in accordance with applicable state… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. The **Senior RFI Analyst** within the Special Investigations Unit ( SIU ) plays a key role in supporting ... fraud, waste, and abuse investigations by managing and responding to Requests for Information...Texas OIG, Florida AHCA) - Prior experience in a SIU or regulatory response role - Knowledge of claims… more
- Allied Universal (Batavia, NY)
- …best, explore a career with us and make a difference. 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 investigations ... (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 (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 (Washington, DC)
- …and production outcome as a subject matter expert on LexisNexis Risk Solutions within the Special Investigations Unit ( SIU ). This is a remote/ home-based ... Risk at the link below. https://risk.lexisnexis.com/government About the TeamThe Public Safety Special Investigative Unit ( SIU ) is comprised of former… more
- Point32Health (Canton, MA)
- …Investigator I is an essential team member of the Special Investigation Init ( SIU ( Special Investigations Unit )) responsible for leading complex ... future loss. The Investigator works closely with other members of the SIU to set investigative priorities, develop effective investigative strategies and techniques,… more
- Centene Corporation (Jefferson City, MO)
- …reporting of instances of potential fraud, waste and abuse no within scope of the Special Investigations Unit . + Prepare periodic reports and, as necessary, ... the continental United States. **Position Purpose:** The VP Corporate Compliance Investigations is responsible for the initial assessment of internal allegations and… more
- Blue KC (Kansas City, MO)
- …assistance** **Employee discount program** **Job Description Summary:** As part of Blue KC's Special Investigations Unit ( SIU ), the Fraud Investigator ... and other resources for potential FWA schemes. + Conduct investigations of fraud, waste and abuse in accordance with... of fraud, waste and abuse in accordance with SIU policies and procedures. May work with Manager and/or… more
