- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...This position will also review database information found in systems such as Unitrac, insurance company websites, Lexis Nexis,… more
- Allied Universal (Waco, TX)
- …difference. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with ... Company Overview: 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
- Allied Universal (Abilene, 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 … more
- Molina Healthcare (Dallas, TX)
- …Tricare, Pharmacy, etc.) + Experience with UNET, Comet, Macess/CSP, or other similar claims processing systems . + Demonstrated ability to use MS Excel/Access ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical… 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
- CVS Health (Austin, TX)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... clinical and legal review. - Documents all appropriate case activity in tracking system . - Makes referrals and deconflictions, both internal and external, in the… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …evidence and education strategies + Contribute to internal process optimization, system improvements (eg, grants management systems ), and reporting dashboards ... generation of medical evidence, (eg, observational studies, registries, and investigator -initiated studies (IISs) / investigator -initiated trials (IITs)) + Manage… more
- Aramco Services Company (Houston, TX)
- …assignments beyond the normal scope of the audit function. The Senior Lead Investigator handles hotline reports or calls and manages cases of moderate to high ... contract compliance, reviews of selected internal controls, reviews of IT systems , and audits of organizations. Audits may be organizational, functional, financial… 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 ... solutions + Establish KPIs for congress activities and implement systems to track and analyze performance + Conduct post-congress...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more