- CVS Health (Tallahassee, FL)
- …Summary** We 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… more
- CVS Health (Tallahassee, FL)
- …The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding ... practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must… more
- Humana (Tallahassee, FL)
- …help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Senior Fraud and ... years of relevant work experience in Fraud & Abuse Investigations required + At least 2 years of healthcare...required + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment… more
- CVS Health (Tallahassee, FL)
- …The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for ... medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company… more
- CVS Health (Tallahassee, FL)
- …waste, abuse (FWA), and compliance violations. This position is embedded within the International Special Investigations Unit (ISIU) and is designed to lead ... with heart, each and every day. **Position Summary** The Senior Analyst, Investigations at Aetna International plays a pivotal role in safeguarding the organization… more
- CVS Health (Tallahassee, FL)
- …can be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit (SIU) is looking for an analytically driven ... and reviewing incoming referrals and leads to determine if additional investigations are warranted. **Key Responsibilities** + Identify, research, analyze and… more
- Allied Universal (Jacksonville, FL)
- …explore a 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
- USAA (Tampa, FL)
- …and policy provisions. + Review claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable. + Maintain ... treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Senior Auto Appraiser, within defined… more
- MyFlorida (Tallahassee, FL)
- …Disposal (EOD) Unit + EOD K-9 Unit + Honor Guard + Investigations Unit + Special Operations Team (SOT) + Promotional Opportunities (Sergeant / ... opportunities include: + Uniform Patrol providing 24/7 coverage + Directed Patrol Unit (Bicycle Patrols / Community Policing / Crime Prevention) + Drone Operations… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... both preliminary assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background checks, data… more