- CVS Health (Albany, NY)
- …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,...abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud,… more
- 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 ... are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire… more
- CVS Health (Albany, NY)
- …day. The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit ( SIU ) to ensure compliance with ... review guidance. + Collaboration with investigators, data analytics and plan leadership on SIU schemes. + Act as management back-up and supports the team when the… more
- City of New York (New York, NY)
- …and/or non-criminal, unique, highly confidential and sensitive investigations . The Special Investigation Unit ( SIU ) is responsible for investigating ... The New York City Department of Correction seeks to recruit Deputy Directors for the Special Investigation Unit ( SIU ). Under the direction of the Executive… more
- CVS Health (Albany, NY)
- …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 (Albany, NY)
- …position can be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit ( SIU ) is looking for an analytically ... and reviewing incoming referrals and leads to determine if additional investigations are warranted. **Key Responsibilities** + Identify, research, analyze and… more
- CVS Health (Albany, NY)
- …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
- Allied Universal (Batavia, NY)
- …best, explore a career with us and make a difference. 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
- Capital One (Jericho, NY)
- AML Sr Investigator II- SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized investigations ... (SME)** will work closely with key stakeholders in the SIU and outside of the SIU when...+ Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in… more
- Excellus BlueCross BlueShield (Rochester, 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