- 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
- Command Investigations (Lubbock, TX)
- Command Investigations, LLC is looking for Claims Investigator to become part of a dynamic team. This is a great opportunity for individuals with prior SIU ... however, we pride ourselves on distributing available cases fairly. Position(s) Available: Claims Investigator Our employees have opportunities to grow within a… more
- Command Investigations (Laredo, TX)
- …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
- 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 - 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
- Allied Universal (Tyler, TX)
- **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
- 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
- The Robison Group (Lubbock, TX)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... + Candidates must be willing to obtain a valid Texas Private Investigator license. + Self-motivated, determined, and intuitive. + Strong initiative and work… more
- CVS Health (Austin, TX)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Research and… more
- Allied Universal (Mcallen, TX)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to… more
- Molina Healthcare (Houston, TX)
- …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... providers that bill Medicaid/Medicare/Marketplace. **KNOWLEDGE/SKILLS/ABILITIES** + Ensure investigators are managing their cases effectively and in accordance with SIU policies, processes, quality standards, and procedures. + Ensure that investigators are… more
- Humana (Austin, TX)
- …Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a corporate ... environment and understanding of business operations **Additional Information** **Work at Home Requirements** * At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested *… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …generation of medical evidence, (eg, observational studies, registries, and investigator -initiated studies (IISs) / investigator -initiated trials (IITs)) + Manage ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …clinical development plans. + Review and approval of clinical study protocols, investigator brochures, study reports, etc. + Support budget and timeline activities ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …Advocacy Groups) before during and after congresses + Organize and facilitate investigator meetings and advisory boards in conjunction with congress + Coordinate ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Parexel (Austin, TX)
- …draft agreed-upon scientific/medical content that addresses data interpretation, product claims , and internal/external questions * Coordinates and delivers document ... members of writing staff, prepares clinical study reports (CSRs), protocols, investigator brochures (IBs), submission data summaries, and other regulatory documents… more