- Command Investigations (Detroit, MI)
- … Investigations ) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator. SuperiorX ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit (SIU) Senior Investigator is to assist in the reduction and recuperation ... assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education...to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education Level:** Bachelor's Degree… more
- CVS Health (Hartford, CT)
- …Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In this role, you will ... manage complex investigations into suspected and known acts of healthcare fraud,...abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud,… more
- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of ... approach, resources, schedules and goals. **Where you Come In** The Special Investigations Unit Manager assists coordinating investigation with law… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to ... the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving...and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities… more
- City of La Mesa, CA (La Mesa, CA)
- …patrol, field training officer, investigations , motor officer, school resource officer, special investigations unit , street team, honor guard and the ... and local traffic regulations; participates in and conducts a variety of criminal investigations ; provides support and assistance to special crime prevention and… more
- M. C. Dean (Vienna, VA)
- …coverage; review the established reserve requirements, identified claims for subrogation and/or Special Investigations Unit as appropriate. + Assesses actual ... regulatory issues and available resources. + Plans and conducts investigations of claims to confirm coverage and to determine...Knowledge and abilities of Microsoft suite of applications with special emphasis on excel and the ability to pivot… more
- Travelers Insurance Company (Lake Oswego, OR)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- Travelers Insurance Company (Fort Worth, TX)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- Highmark Health (Albany, NY)
- …and provides supporting documentation. *Identifies potential fraud cases and forwards to Special Investigations Unit . E3. Adjusts claims: *Performs online ... providers, internal and external customers; Adjusts claims. This is a bargaining unit position. The collective bargaining agreement for this position requires that… more