- Terumo Medical Corporation (Somerset, NJ)
- …of risk and benefits of Terumo devices. + Create and/or review product claims based on the existing clinical and nonclinical evidence. + Study (summary) protocols. ... + Write investigator brochures, interim and final clinical study reports, briefing documents (including internal summary reviews for internal and external purpose… more
- Allied Universal (Queens, NY)
- …on the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for ... **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....+ Ability to be properly licensed as a Private Investigator as required by the states in which you… more
- Command Investigations (New York, NY)
- …for hire. Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, ... Auto, or Homeowners Investigations. + Writing accurate, detailed reports + Strong initiative, integrity, and work ethic + Securing written/recorded statements + Accident scene investigations + Possession of a valid driver's license + Ability to prioritize and… more
- NJ Transit (Newark, NJ)
- Investigator A ( Claims ) Finance Job Description: Move forward with us! At NJ TRANSIT, you'll join us in transforming the third-largest transportation agency in ... and other public agencies. + Carrying out negotiations in adjusting of claims and entering of settlements with attorneys. + Obtaining information in collection… more
- Allied Universal (Staten Island, NY)
- …Description:** Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims ... **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....+ Ability to be properly licensed as a Private Investigator as required by the state where work Is… more
- Molina Healthcare (Yonkers, 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 on… more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Insurance Fund, State Title Investigator 1, Senior Investigative Officer Occupational Category Other Professional Careers Salary Grade NS ... and mitigate fraud. DCI is comprised of four separate teams: Claims Fraud, Provider Fraud, Policyholder Fraud and Data Analytics.Responsibilities include, but… more
- USAA (New York, NY)
- …us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). This is a desk position. Within defined guidelines and framework, ... protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Specialist Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... recommendations. 5. In conjunction with the assigned Incident Management Investigator Specialist, prepares investigative reports and forwards completed reports to… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Specialist Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=6481) Job Brief Assists the Incident Management Investigator with conducting investigations into situations, which may violate… more
- Allied Universal (Brooklyn, NY)
- **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... and eligibility. **Job Description:** Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet mobile and… more
- Elevance Health (Woodbridge, NJ)
- **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 (Yonkers, NY)
- **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
- The Robison Group (Newark, NJ)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... + Must be willing and able to obtain a New Jersey Private Investigator 's license TRAINING The Robison Group provides remote and/or in-classroom training to ensure… more
- The Robison Group (Brooklyn, NY)
- …such as auto and property theft, fire damages, auto accidents, commercial claims , finding missing persons, courthouse searches, and other investigative tasks. For ... for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible team of investigators and industry… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... (CQI) teams, consistent adherence to the specific rules and regulations of the BronxCare Health System (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient and… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE. The DSS Accountability Office (DSS-AO) is responsible for ... all statutory, regulatory, and contractual standards. The Division of Claims and Collections Division (C&C) is housed within the...levels. C&C is recruiting for (1) one Associate Fraud Investigator II to function as a Group Supervisor, who… more
- Mount Sinai Health System (New York, NY)
- …to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The ... with a strong understanding of both hospital and professional claims processes. ? Previous experience in a role that...and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and ... required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ,… more
- Mount Sinai Health System (New York, NY)
- …Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with ... problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the...and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges.… more
