• Claims Investigator

    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
    Allied Solutions (07/13/25)
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  • Investigator , Special Investigative Unit

    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
    Molina Healthcare (07/19/25)
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  • Investigator Senior

    Elevance Health (Grand Prairie, TX)
    ** Investigator Senior** **Supports the Payment Integrity line of business** **Virtual:** This role enables associates to work virtually full-time, with the exception ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
    Elevance Health (06/27/25)
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  • Surveillance Investigator

    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
    Allied Universal (07/11/25)
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  • Clinical Fraud Investigator II - Registered…

    Elevance Health (Grand Prairie, TX)
    **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that… more
    Elevance Health (07/02/25)
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  • Special Investigation Unit: Coordinator

    Kemper (Dallas, TX)
    …College Degree or equivalent work experience * Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong ... and/or Analytics Academies are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA)… more
    Kemper (07/02/25)
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