- CVS Health (Topeka, KS)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a… more
- CVS Health (Morgantown, WV)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known or… more
- Allied Universal (Casper, WY)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic...life, AD&D, and disability insurance + Enrollment in our company 's 401(k)plan, subject to eligibility requirements + Seven paid… more
- Molina Healthcare (Cincinnati, OH)
- …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... Create, edit, and update assigned reports to apprise the company on the team's progress. + Distribute reports to...Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care… more
- The Boeing Company (Ridley Park, PA)
- …operations) identified over the course of an investigation using existing company safety processes + Ability to quickly understand technical information that ... + Assists with investigations of accidents and incidents involving company products and services. Participates in company ...+ Participates in the discussion of legal cases and claims with in-house and outside counsel. + Researches, acquires… more
- Humana (Lansing, MI)
- …Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a corporate ... for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its… more
- Philadelphia Insurance Companies (Ewing, NJ)
- …to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is ... by AM Best. We are looking for a Sr. Claims Examiner - SIU to join our team! Summary...investigators conduct appropriate investigations. Review and evaluation of third-party investigator reports for thoroughness and accuracy. Review and evaluation… more
- C&S Wholesale Grocers, Inc. (Lathrop, CA)
- **Position Overview** As a Claims Investigator , you will be researching shortage claims based on calls received from our customer locations. These ... Description** **Description** + This position will report directly to the Claims Manager and conduct detailed investigations by recovering all documentation… more
- Travelers Insurance Company (Hartford, CT)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The hourly salary range provided for this position is a ... receiving valuable on-the-job training, and learns about the Fire Investigator professions available at Travelers. Interns receive challenging work assignments… more
- Fallon Health (Worcester, MA)
- …initial investigator for provider appeals related to filing limit, claim denials, claim payment, retrospective referrals, administrative inpatient days and ... **Overview** **About us:** Fallon Health is a company that cares. We prioritize our members-always-making sure...each department per week. + Act as the initial investigator and contact person for grievances and appeals, which… more