- AIG (Atlanta, GA)
- …and reporting on findings. The investigator will provide assistance to the claims adjuster in progressing the claim and will leverage knowledge and expertise ... customers to manage risk. Join us as a Principal Claims Investigator to play your part in...business involving claimants, brokers, lawyers, medical providers, etc., to support the Claims organization. + Obtain and… more
- State of Colorado (Lakewood, CO)
- Criminal Investigator III - Lottery Divsion Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5150451) Apply Criminal Investigator III - ... quality customer service, innovation, and collaboration. We celebrate diversity and support an equitable and inclusive culture. We embrace our differences because… more
- Elevance Health (Indianapolis, IN)
- …eliminate and prevent unnecessary medical-expense spending. **Title:** Sr Investigator **Locations:** Indianapolis, IN, Columbus, OH, Nashville, TN **Hybrid:** ... week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... All Levels + Must meet the NYS DFS's and the NYS OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified… more
- Prime Therapeutics (Salem, OR)
- …of pharmacy with us. **Job Posting Title** Special Investigations Unit (SIU) Investigator - Remote **Job Description** The Special Investigations Unit (SIU) ... Investigator is responsible for conducting standard investigations of potential...prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... justice or a related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation experience with law… more
- UPMC (Pittsburgh, PA)
- …UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator position. This is a temporary position working Monday through Friday 8:00 ... direction of the manager, the Special Investigations Unit (SIU) Investigator is responsible for investigating assigned fraud, waste and...abuse (FWA) cases, as well as researching and analyzing claims data in order to identify potential FWA. The… more
- USAA (Cheyenne, WY)
- …us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). This is a Desk position. Within defined guidelines and framework, ... protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance… more
- State of Michigan (Flint, MI)
- Civil Rights Investigator - Flint Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5142586) Apply Civil Rights Investigator - Flint Salary ... and education, and community engagement. In this important role, an investigator is responsible for investigation and/or resolution of complaints of unlawful… more
- AmeriHealth Caritas (Columbia, SC)
- …services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported, ... Proactively performs research using the Internet, data analysis tools, etc., to analyze aberrant; claims billing and practice patterns. + Analyzes data as part of the… more