- 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
- Molina Healthcare (Dallas, 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)
- ** Investigator Senior** **Location Hybrid 1** : This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, ... and adaptable workplace. Alternate locations may be considered. The ** Investigator Senior** position is responsible for the independent identification, investigation… more
- 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
- Allied Universal (Dallas, 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
- 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
- Molina Healthcare (Dallas, 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** **Location:** Hybrid 1: This role requires associates to be in-office **1-2** days per week, fostering collaboration and connectivity, while ... 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
- 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
- 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