- Allied Universal (Orange, CA)
- …plans, employee assistance programs, and exclusive perks. 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
- CVS Health (Sacramento, CA)
- …and more compassionate. And we do it all with heart, each and every day. Medical Director - SIU ( Special Investigations Unit ) CVS Health - Special ... **This is a remote based, work from home role.** Key Responsibilities: The Special Investigations Unit ( SIU ) Medical Director will be responsible for… more
- JPMorgan Chase (Jersey City, NJ)
- …security solutions, ensuring a safer and more secure future for all. As a Special Investigations Unit Investigator within the Global Security team, you ... will be responsible for conducting complex and sensitive investigations involving Code of Conduct violations in both North America and Latin America and coordinate… more
- CVS Health (Springfield, IL)
- …with heart, each and every day. Come work for Aetna Better Health of Illinois and the Special Investigations Unit ( SIU )! **Position Summary** The SIU ... 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
- The Robison Group (Fort Myers, FL)
- …searches, and other investigative tasks. 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
- CVS Health (Pierre, SD)
- …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
- City of New York (New York, NY)
- …seeks to recruit a SIU Data Analyst (community coordinator) to work on its Special Investigations Unit , PREA Investigations team. Under the direction ... of a Deputy Director for the SIU PREA Team and with latitude to exercise independent...will be responsible to work closely with the PREA Investigations Supervisors and Investigators to assist in the accurate… 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
- 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
- Banco Popular Puerto Rico (San Juan, PR)
- … Investigations Manager is responsible for leading the Continuous Audits and Special Investigations unit , which is tasked with conducting continuous ... associated with business processes and develop risk mitigation strategies. + Special Investigations : Oversee the investigation of customer claims, allegations,… more
- Kemper (Henderson, NV)
- …by law and management. + Responsible for communicating critical situations to the Special Investigation Unit and field managers. + Develops and maintains ... to our stakeholders that delivers on our promises._ **Position Summary** : The SIU Desk Investigator I is responsible for the investigation of simple claims that… 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 (Franklin, TN)
- …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 (Hunt Valley, MD)
- …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
- Sedgwick (Irving, TX)
- …changes with internal departments. + Provides referrals to legal, utilization review, pharmacy, and Special Investigations Unit ( SIU ) as appropriate and ... coordinates independent medical examinations. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** High school diploma or GED required.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit ( SIU ), Provider Relations (PR), or ... Sales & Marketing. + Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects of the Case Management department functions including quality,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …agencies (eg APS/CPS) as needed, and any suspected/possible Medicaid fraud to the Special Investigations Unit ( SIU ) or designated internal/external ... entity.* Communicates with all internal and external stakeholders to obtain the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members.* Adheres to all Corporate and Departmental policies… more
- USAA (Gainesville, FL)
- …and policy provisions. + Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable. + Maintains ... treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Senior Auto Appraiser, within defined… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions… more
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