- The Robison Group (Brooklyn, NY)
- …writing, reading and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and...+ Make sound judgments during the course of the investigation . + Provide timely progress updates. + Complete detailed… more
- CVS Health (Albany, NY)
- …Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's Special Investigations Unit . In this role, you will ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.… more
- Humana (Albany, NY)
- …and help us put health first** The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ... resources, schedules and goals. The Manager, Fraud and Waste coordinates investigation with law enforcement authorities. Assembles evidence and documentation to… more
- Allied Universal (Staten Island, NY)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor **QUALIFICATIONS (MUST HAVE):**… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit ( SIU ), Provider Relations (PR), or ... Sales & Marketing. + Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects of the Case Management department functions including quality,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …agencies (eg APS/CPS) as needed, and any suspected/possible Medicaid fraud to the Special Investigations Unit ( SIU ) or designated internal/external ... entity. + Communicates with all internal and external stakeholders to obtain the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members. + Adheres to all Corporate and Departmental policies… more
- Allied Universal (Buffalo, NY)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
- USAA (New York, NY)
- …characteristics. + Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit ( SIU ) referrals, when ... we treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Property Adjuster Specialist , you will… more
- New York State Civil Service (Syracuse, NY)
- …No Telecommuting allowed? Yes County Onondaga Street Address Syracuse Regional Office - Special Investigations 333 East Washington St, City Syracuse State NY Zip ... Occupational Category Enforcement or Protective Services Salary Grade 23 Bargaining Unit M/C - Managerial/Confidential (Unrepresented) Salary Range From $86773 to… more