- CVS Health (Atlanta, GA)
- …are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a specific self-funded ... plan sponsor. In this role, you will manage complex investigations into suspected and known acts of healthcare fraud, waste and abuse (FWA). **Key Responsibilities**… more
- Allied Universal (Macon, GA)
- …career with us and make a difference. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations ... ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor **QUALIFICATIONS (MUST HAVE):** + Must… more
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including Microsoft Word (edit/save documents) and… more
- Molina Healthcare (Atlanta, GA)
- …to the SIU Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight and guidance throughout the ... and assignments effectively and timely. + Manage the flow of day-to-day investigations . + Perform assessment that QA measures were complete and signed-off +… more
- Elevance Health (Atlanta, GA)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Clinical Fraud Investigator II - Registered Nurse and CPC -...clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims… more