- Capital One (Richmond, VA)
- AML Sr. Investigator I - Special Investigations Unit **AML Sr. Investigator I - Special Investigations Unit ** The Anti-Money Laundering (AML) Sr. ... Supervisors and Managers to perform other critical functions. The Special Investigations Unit conducts suspicious...+ Self-manage a queue of alerts, cases, and closing investigations + Helps maintain operations of a SIU… more
- The Robison Group (Oklahoma City, OK)
- …searches, and other investigative tasks. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and...+ Make sound judgments during the course of the investigation . + Provide timely progress updates. + Complete detailed… more
- CVS Health (Richmond, VA)
- …experience with medical record review within a healthcare insurance company. - Prior special investigation unit experience. - Excellent analytical skills. - ... Excellent communication skills. **Education** - GED or equivalent - AAPC Certified Professional Coder Certification (CPC) **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $43,888.00 - $102,081.00… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. The **Senior RFI Analyst** within the Special Investigations Unit ( SIU ) plays a key role in supporting ... fraud, waste, and abuse investigations by managing and responding to Requests for Information...Medicaid and Medicare programs - Familiarity with state-specific fraud investigation protocols (eg, Texas OIG, Florida AHCA) - Prior… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... SIU related requirements. Prepares detailed preliminary and extensive investigation referrals to state and/or federal regulatory and/or law enforcement agencies… more
- CVS Health (Albany, NY)
- …Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's Special Investigations Unit . In this role, you will ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.… more
- Geisinger (Danville, PA)
- …Responsible for the strategic direction, planning, oversight, and operation of the Special Investigations ("SI") and Program Integrity ("PI") teams. Develops and ... directs the prevention, detection and investigation of anti-fraud, waste and abuse (FWA)program processes and...Job Duties + Provides leadership and strategic direction of Special Investigations and Program Integrity units spanning… more
- CVS Health (Harrisburg, PA)
- …**Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and prosecution ... in identifying resources and best course of action on investigations . - Cooperates with federal, state, and local law...federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters.… more
- CVS Health (Hartford, CT)
- …be flexible to work EDT hours (8:00 am - 5 pm EDT) Conducts investigations to effectively pursue the prevention, detection, investigation and prosecution of ... agencies as required by law and regulation. **Fundamental Components:** - Conducts investigations of known or suspected acts of healthcare fraud, waste, and abuse… more
- Molina Healthcare (Covington, KY)
- … investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the SIU referral intake and investigation process while giving guidance and ... direction to team on case investigation steps and actions. + Works with leadership to maintain and revise policies and procedures, fraud, waste, and abuse plans,… more