- Sedgwick (Madison, WI)
- …Loved Workplace(R) Forbes Best-in-State Employer SIU Research Investigator **PRIMARY PURPOSE** **:** To perform claims investigations utilizing online ... public and subscription database searches; to conduct various research investigations using specialized techniques and technologies; to analyze results for red… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The SIU Special Investigator will be responsible for investigating complex insurance ... cases to detect internal and external fraud and abuse. The Special Investigator will research and document cases utilizing resources available to identify… more
- Allied Universal (Des Moines, IA)
- …most full-time compliance and investigation jobs! Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator . Special ... and case managers, by means of data collection, interviews, research and collaboration with other SIU entities,...Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance… more
- CVS Health (Springfield, IL)
- …health care more personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of known or ... Investigators. Assists Investigators in identifying resources and best course of action on investigations * Serves as back up to the Team Leader as necessary In… more
- Point32Health (Canton, MA)
- …to join our organization as a nInvestigator within our Special Investigations Unit (" SIU "). The Investigator is an essential team member of the ... SIU , responsible for leading complex provider investigations related to fraud, waste and abuse, and developing action plans to address the investigative findings… more
- Molina Healthcare (Omaha, NE)
- **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
- LTCG (MN)
- …and success of its customers. With illumifin, there's a brighter future A SIU /Fraud Investigator is responsible for working with multiple business units on ... programs and from claims organization, as assigned * Coordinates and performs investigations with oversight of lead investigator * Prepares responses for… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Associate Investigator works with a growing team conducting and managing Health Care Fraud, Waste and Abuse investigation ... Exercised:** No **What You'll Be Doing:** + Plan, organize, and execute investigations or audits utilizing document review, witness interviews and data analysis to… more
- CVS Health (Baton Rouge, LA)
- …make health care more personal, convenient and affordable. Position SummaryAs 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 Leader...know how to do pivot tables).- Strong analytical and research skills. - Proficient in researching information and identifying… more
- CVS Health (Hartford, CT)
- …3 years of investigative related experience working in fraud, waste and abuse investigations and audits. - Strong analytical and research skills. - Proficient ... United States. Must be willing to work EDT schedule. - Conducts investigations to effectively pursue the prevention, investigation, and prosecution of healthcare… more
- CVS Health (Trenton, NJ)
- …Over 3 years in healthcare field working in fraud, waste and abuse investigations and audits.- Strong analytical and research skills.- Proficient in researching ... care more personal, convenient and affordable. Position Summary- Conducts investigations to effectively pursue the prevention, investigation, and prosecution of… more
- CVS Health (Tallahassee, FL)
- …regulations mandating fraud plans. Fundamental Components: - Conducts high level, complex investigations of known or suspected acts of healthcare fraud and abuse. - ... in identifying resources and best course of action on investigations . - Serves as back up to the Team...evaluate medical related claims . - Strong analytical and research skills. - Proficient in researching information and identifying… more
- CareFirst (Baltimore, MD)
- …programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Special Investigations Unit **Equal Employment Opportunity** ... assess financial impact of potential cases. + Proactively conduct research and analysis support for the department and to...Waste and Abuse case management system. Monitor and notify SIU associates on dollar recovery and Corrective Action Plan… more
- City of New York (New York, NY)
- Job Description The Special Investigations Unit ( SIU ) of the Law Department conducts Investigations . In-House investigations include, but are not ... action. Under general supervision, with latitude for independent initiative and judgment, SIU Team members conduct professional investigations of varying degrees… more
- Idaho Division of Human Resources (Boise, ID)
- …operations. The position reports directly to the Chief Investigator of the IDOC Special Investigations Unit ( SIU ). This position is located at ... IDOC - Investigator (Internal Affairs) Posting Begin Date: 2024/05/16 Posting...83706. Responsibilities: + Plan, organize, and conduct internal affairs investigations and investigative activities statewide. + Research … more
- System One (Baltimore, MD)
- … to support a leading health insurance customer. The individual will work with the Special Investigations Unit ( SIU ) to assist in the reduction ... and recuperation of losses. You will research and analyze data using company anti-fraud software, Excel,...Baltimore, MD (Hybrid) twice a week Job Duties: + Research provider/subscriber claims activity, operations manuals, data systems, medical… more
- Commonwealth Care Alliance (Boston, MA)
- … Coder Sr. Associate is an integral part of the Fraud, Waste & Abuse (FWA) Special Investigation Unit ( SIU ). The position reports directly to the Sr. ... CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and applies… more
- Allied Universal (Beckley, WV)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... clients and case managers through various methods such as data collection, interviews, research , and scene investigations + Follow guidance from the handling… more