- CDPHP (Latham, 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
- MTA (New York, NY)
- …the development of routine quality assurance evaluations in collaboration with Security Special Investigations unit (s), MTA Legal, Labor relations, the ... Director, Quality Assurance Job ID: 13522 Business Unit : MTA Headquarters Location: New York, NY, United States Regular/Temporary: Regular Department: HQ Office of… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions… more
- Molina Healthcare (Rochester, NY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager, SIU , the Team Lead is responsible to lead a small team of investigators and provide ... on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking...Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight… more
- Molina Healthcare (NY)
- …hospital, clinic settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical… more
- Allied Universal (Saratoga Springs, NY)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation… more
- USAA (New York, NY)
- …+ Identifies coverage concerns, reviews prior loss history, determines, and creates Special Investigation Unit ( SIU ) referrals, when appropriate. + ... Agent (Army MOS 31D or Marine Corps 5821), Air Force Office of Special Investigations (OSI) Agent (Air Force Enlisted Code 7S), or in a Military Police (MP)… more