- Elevance Health (Richmond, VA)
- …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
- Travelers Insurance Company (Diamond Bar, CA)
- …and combat fraudulent practices at scale. As an SIU Specialized Investigator , you will lead complex, multi-claim investigations with regional and national ... accelerate case development, and support data-driven strategies in major case investigations . **What Will You Do?** + Proactively analyzes highly technical… more
- CVS Health (Charleston, WV)
- …every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known ... in identifying resources and best course of action on investigations + Serves as back up to the Team...years of working health care fraud, waste and abuse investigations ). **Anticipated Weekly Hours** 40 **Time Type** Full time… more
- Centene Corporation (Sacramento, CA)
- …and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud ... and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document...referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as… more
- 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 identifying resources and best course of action on investigations . - Cooperates with federal, state, and local law...experience working on health care fraud, waste, and abuse investigations and audits required or equivalent investigations … more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and...assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background… 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 (Rochester, 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...involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
- Allied Universal (Fargo, ND)
- …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation… more
- New York State Civil Service (Syracuse, NY)
- …No Telecommuting allowed? Yes County Onondaga Street Address Syracuse Regional Office - Special Investigations 333 East Washington St, City Syracuse State NY Zip ... at administrative hearings and criminal proceedings; experience as a police investigator ; and/or conducting child welfare investigations , such as those… more