- Point32Health (Canton, MA)
- …about who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Investigator I is an essential team member of the Special Investigation Unit ... ("FWA") investigations under the direction of the Manager, FWA Prepayment Review. The Investigator I works closely with other members of the SIU to set investigative… more
- CVS Health (Columbus, OH)
- …it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts ... fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business +...+ The ability to understand and analyze health care claims and coding + Ability to travel up to… more
- Elevance Health (St. Louis, MO)
- …in order to recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible for identifying and developing ... more than one company health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and… more
- Command Investigations (Syracuse, NY)
- …the frontline of the private investigations industry. The primary responsibility of the Investigator is to conduct mobile surveillance of an individual that has an ... on-going insurance claim . Surveillance is conducted in order to document (on video) the individual's daily activities and to ensure that their injuries coincide with… more
- CVS Health (Topeka, KS)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Research and… more
- Marshfield Clinic (Marshfield, WI)
- …most exciting missions in the world!** **Job Title:** Subrogation Investigator **Cost Center:** 682891012 SHP-Legal-Subrogation **Scheduled Weekly Hours:** 40 ... Required: Two years previous work experience in collections, legal, claims processing, or subrogation related field. Preferred/Optional Experience: Qualified… more
- Highmark Health (Pittsburgh, PA)
- …Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment ... methodology, claims processing systems and coding and billing proficiency + Must have understanding of technical and financial aspects of the health insurance… more
- The Robison Group (Brooklyn, NY)
- …such as auto and property theft, fire damages, auto accidents, commercial claims , finding missing persons, courthouse searches, and other investigative tasks. For ... for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible team of investigators and industry… more
- Command Investigations (Baltimore, MD)
- Seeking experienced Claims /SIU and/or Workers' Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and ... Visit our website and find out why at www.GoCommand.com. The SIU/WC Investigator should demonstrate proficiency in the following areas: + Multi-lines Investigations… more
- Allied Universal (Portland, OR)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more