• Investigator, Special Investigative Unit…

    Molina Healthcare (Owensboro, KY)
    …opinions. + Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations . + Knowledge of Managed Care and the Medicaid and ... medical records and data analysis, and makes determinations as to whether the investigation and/or audit identified potential fraud , waste, or abuse. +… more
    Molina Healthcare (07/24/25)
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  • Special Investigations Unit (SIU)…

    Allied Universal (Louisville, KY)
    …(5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud + Ability to be properly licensed as ... Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
    Allied Universal (07/30/25)
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  • Manager, Fraud and Waste

    Humana (Frankfort, KY)
    …approach, resources, schedules and goals. **Where you Come In** The Special Investigations Unit Manager assists coordinating investigation with law enforcement ... of our caring community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of fraudulent… more
    Humana (08/09/25)
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  • Manager, Special Investigation

    CVS Health (Frankfort, KY)
    …Job Description **A Brief Overview** Oversees corporate activities related to the prevention, investigation , and prosecution of health care fraud to recover lost ... of investigators and analysts to effectively pursue the prevention, investigation and prosecution of healthcare fraud and...Leads a team in the planning and execution of investigations of acts of healthcare fraud and… more
    CVS Health (08/01/25)
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  • Director, Protection Services Operations Center…

    Molina Healthcare (KY)
    …(PSOC) Team. Responsible for the monitoring and intelligence, incident response, and investigations programs which are in place to avoid business disruption, threats ... as possible. **Job Duties** + Responsible for operational physical security, investigations , and incident response for the enterprise to proactively monitor,… more
    Molina Healthcare (06/29/25)
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  • Senior AML Investigations Trainer

    Coinbase (Frankfort, KY)
    …connection, and alignment. Attendance is expected and fully supported. Senior AML Investigations Trainer provides end to end learning services, and management for ... job requirements): * Minimum 2 years of formal experience training AML, Fraud or other Compliance-related pillars. * Proven track record of successfully managing… more
    Coinbase (08/09/25)
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  • Special Investigation Unit (SIU) Coding…

    CVS Health (Frankfort, KY)
    …Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record ... federal policies, and identify potential billing errors, abuse, and fraud . + Identify opportunities for savings related to potential...of 2 years of managing staff within a Special Investigation Unit (SIU). + Excellent analytical skills and the… more
    CVS Health (08/08/25)
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  • SIU Specialist - Pharmacy Tech - Remote in…

    Prime Therapeutics (Frankfort, KY)
    …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... for work visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations /claims experience. + Ability to manage workload while… more
    Prime Therapeutics (06/24/25)
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  • Payments Risk Analyst I, Operations (Platform)

    Coinbase (Frankfort, KY)
    …, identify patterns, and find the root cause. * A passion for fighting fraud . * The curiosity to self-drive investigations , identify patterns, and find the ... You will be fully responsible and accountable for the end-to-end investigation and resolution of risk-related escalations involving any of Coinbase's diverse… more
    Coinbase (08/09/25)
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  • Quality Reviewer (Aetna SIU)

    CVS Health (Frankfort, KY)
    …**Education** + A Bachelors degree or three years of experience in healthcare fraud , waste, and abuse investigations and audits. **Anticipated Weekly Hours** 40 ... **Position Summary** + Assess the thoroughness and accuracy of investigations aimed at preventing payment of fraudulent claims by...Support the recovery of company funds lost due to fraud by providing insights and recommendations based on case… more
    CVS Health (08/08/25)
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