- Allied Universal (Mcdonough, GA)
- …perks. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Elevance Health (Atlanta, GA)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... ** Investigator Senior** **Supports the Payment Integrity line of...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- Highmark Health (Atlanta, GA)
- … (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have ... understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed oriented… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …role will take a leadership position in the conduct of clinical facility and system audits at all relevant facilities, investigator sites, and vendors (including ... and correcting non-compliance and mitigating risks, The performance of the Quality Systems and Risks will be reported periodically to Senior Management through the… more
- CVS Health (Atlanta, GA)
- …each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more