- USAA (Columbus, OH)
- …truly makes us special and impactful. **The Opportunity** As a dedicated **Manager, Special Investigations Unit for Property & Casualty** , you will be ... to demonstrate monthly productivity and cycle time outcomes from investigations assigned to the SIU team. +...teams. **What sets you apart:** + 2+ years of SIU investigator experience. + Current or prior… more
- Humana (Dayton, OH)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... Department of Medicaid (ODM) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in Ohio to increase… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including Microsoft Word (edit/save… more
- Centene Corporation (Columbus, OH)
- …including a fresh perspective on workplace flexibility. **Please note: this is a remote position, however, candidates who reside in the state of Ohio are highly ... and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud… more
- Molina Healthcare (Dayton, OH)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... that may 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
- AmeriHealth Caritas (Columbus, OH)
- … investigations . + Performs necessary functions to support all aspects of SIU investigations and responsibilities to include, but not limited to: Intake; ... Special Investigation Units and fraud, waste and abuse investigations . + Conducts investigations of potential; fraud,...in lieu of formal educational requirements for the Lead SIU Investigator position may be considered.; +… more