- Allied Universal (Charlottesville, VA)
- …**Private Investigator's license** **required** **prior to applying** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. ... Special Investigations Unit ( SIU ) Specialists investigate claims with red flags that suggest...SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud … more
- Donegal Insurance Group (Marietta, PA)
- …Group has an opening for a SIU Desk Investigator that is part of the Special Investigation Unit . As a member of our Claims team, this position will be ... handling of claim cases and investigative support that require special investigative skills and experience. Some travel may be...Degree + Minimum of 3 to 5 years of Insurance Fraud or Insurance related… more
- MAPFRE Insurance (MA)
- …and proper use of MGL Chapter 175 Section 113H or similar state specific fraud statutes. + Insurance coursework strongly preferred, eg SCLA, CIFR or CIFI ... Field Investigator, SIU Date: Aug 5, 2025 Location: MA, US...also include the assisting of Medical Provider, Underwriting, Agency investigations as well as any other investigative needs that… more
- CVS Health (Lansing, MI)
- …medical record review within a healthcare insurance company. - Prior special investigation unit experience. - Excellent analytical skills. - Excellent ... state and federal policies. - Identify potential billing errors, abuse, and fraud . - Identify opportunities for savings related to potential cases which may… more
- Elevance Health (Woburn, MA)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU ** **Location:** This role requires associates to be in-office 1 - 2… more
- Centene Corporation (Austin, TX)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The SIU Program Manager role will support the organizations efforts to detect ... and prevent fraud and abuse by supporting the partnership with our...role will be tasked with developing partnerships beyond that SIU to bring a novel approach to expanding features… more
- Prime Therapeutics (Des Moines, IA)
- …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... and drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the...visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations /claims experience. + Ability to manage… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Senior Investigator is to assist in the reduction and ... State/Federal criminal statutes and criminal and civil law impacting insurance fraud /abuse investigations to preserve...assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education… more
- Centene Corporation (Sacramento, CA)
- … investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste, abuse, and ... fraud + Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and...referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as… more
- Allied Universal (Buffalo, NY)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims +...+ Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud… more