- Allied Solutions (Plano, TX)
- …and exceed all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim… more
- Elevance Health (Grand Prairie, TX)
- **Carelon Coordination of Benefits (COB) - Investigator II** Internal Job Title: Financial Operations Recovery Specialist II **Location:** This role enables ... expenses, making a significant impact on our mission. The **Carelon COB Investigator II (** Financial Operations Recovery Specialist II) is tasked with conducting… more
- Molina Healthcare (Fort Worth, TX)
- **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 on… more
- Elevance Health (Grand Prairie, TX)
- **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... and adaptable workplace. Alternate locations may be considered. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that may… more
- Elevance Health (Grand Prairie, TX)
- ** Investigator Senior** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per week, ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- Allied Universal (Fort Worth, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... cover fuel and travel expenses** Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet mobile and… more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims… more
- Elevance Health (Grand Prairie, TX)
- ** Investigator I** **Carelon Payment Integrity** is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is ... and adaptable workplace. Alternate locations may be considered. The ** INVESTIGATOR I** is responsible for investigating assigned cases, collecting, researching… more
- Travelers Insurance Company (Richardson, TX)
- …provides industry-leading resources designed to detect and deter fraudulent claims . Leveraging advanced technology and analytics, we proactively identify risk ... and combat fraudulent practices at scale. As an SIU Specialized Investigator , you will lead complex, multi-claim investigations with regional and national… more
- Merck (Dallas, TX)
- …in the company's areas of interest _*Scientific exchange does not include promotional claims about any drug, vaccine, or biologic product. RMSDs have no sales ... approved, in development and active Company-Sponsored Trials and/or company Investigator -Sponsored Program (MISP) and Oncology Translational Studies Program (OTSP)… more