• Investigator , Coding Special…

    Molina Healthcare (NY)
    **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by ... GED (or higher) **Required Experience** + 3+ years CPT coding experience (surgical, hospital, clinic settings) or 5+ years...5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge… more
    Molina Healthcare (10/22/25)
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  • Investigator , Special Investigative…

    Molina Healthcare (Syracuse, NY)
    **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... also include coding and billing reviews. The SIU Investigator is responsible for reviewing and...assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background… more
    Molina Healthcare (09/22/25)
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  • Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall ... criminal justice or related field; or employment as an investigator in the SIU on or before...and supporting systems. (BREADTH). + Expertise in complex clinical coding /reviewing assignments, difficult investigations and highly visible… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Clinical Investigator

    MVP Health Care (Rochester, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication...involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
    MVP Health Care (09/20/25)
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