- CVS Health (Harrisburg, PA)
- …all with heart, each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Senior Investigator is to assist in the reduction and ... projects as assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education Level:** Bachelor's Degree… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw… more
- Command Investigations (Detroit, MI)
- …) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator . SuperiorX Investigations ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- MVP Health Care (Schenectady, 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 ... a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication...related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation… more
- Allied Universal (Pensacola, FL)
- …with at least one year of driving experience** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
- The Robison Group (Omaha, NE)
- Individuals selected for the position will be expected to perform investigations of workers compensation claims , liability investigations , multi-line ... We are looking for people who are enthusiastic about investigations , those who thrive in a diverse work environment,...POSITION QUALIFICATIONS: + A current and valid Nebraska Private Investigator license is highly preferred. Ability to obtain an… more
- CVS Health (Albany, NY)
- …Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's Special Investigations Unit . In this role, you will manage ... + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and prepares… more
- CVS Health (Hartford, CT)
- …- Exhibits behaviors outlined in Employee Competencies - Exhibits behaviors outlined in SIU Investigator Competencies - May include travel to testify in court ... flexible to work EDT hours (8:00 am - 5 pm EDT) Conducts investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare… more
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