- CVS Health (Sacramento, CA)
- …with medical record review within a healthcare insurance company. - Prior special investigation unit experience. - Excellent analytical skills. - Excellent ... communication skills. **Education** - GED or equivalent - AAPC Certified Professional Coder Certification (CPC) **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $43,888.00 - $102,081.00 This pay… more
- Allied Universal (Orange, CA)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… more
- CVS Health (Sacramento, CA)
- …Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit ( SIU ) to ensure compliance with ... Qualifications:** + A minimum of 2 years of managing staff within a Special Investigation Unit ( SIU ). + Excellent analytical skills and the ability to mentor… more
- Command Investigations (Ventura County, CA)
- Experienced SIU Investigator A minimum of 5 years' SIU experience is required. Must have background in handling P&C investigations . Candidates who do not ... staff. This is a W-2 role; subcontractors will not be considered. The SIU /Insurance Investigator should demonstrate proficiency in the following areas: + P&C … more
- Command Investigations (San Diego, CA)
- SIU INVESTIGATOR A minimum of 5 years' SIU experience is required. Must have experience in Commercial and P&C investigations . * Candidates who do not have ... assignments. This is a W-2 role; subcontractors will not be considered. The SIU Investigator should demonstrate proficiency in the following areas: + P&C … more
- Travelers Insurance Company (Diamond Bar, CA)
- … SIU Specialized Investigator, you will lead complex, multi-claim investigations with regional and national impact-often involving potential litigation. This role ... accelerate case development, and support data-driven strategies in major case investigations . **What Will You Do?** + Proactively analyzes highly technical… more
- Centene Corporation (Sacramento, CA)
- …and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud ... and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document...referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as… more
- Travelers Insurance Company (West Hollywood, CA)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- Travelers Insurance Company (Gardena, CA)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- CVS Health (Sacramento, CA)
- …methods, and treatment protocols. + Serve as a clinical SME supporting SIU Investigators, Managers, and Directors as appropriate in matters pertaining to the ... cases. Completion of Fraud waste and abuse reviews in partnership with SIU + Provide SME support to enterprise-wide initiatives supporting members with… more