- Allied Universal (Milwaukee, WI)
- 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...and exclusive perks. Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet… more
- Molina Healthcare (Milwaukee, WI)
- **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 (Waukesha, WI)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... ** Investigator II** **Location Hybrid 1** : This role...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- Highmark Health (Madison, WI)
- … (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. (Madison, WI)
- …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