- Capital One (New Orleans, LA)
- AML Sr Investigator II-SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized investigations to ... of ideas + Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in a leadership capacity… 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
- NJM Insurance (Trenton, NJ)
- …Collections every 60-90 days for status; and assist GC Legal in reviewing the NJM Special Investigations Unit (SIU) fraud investigations . + Prepare ... annual review of outside counsel using data provided from various sources including financial metrics databases, the NJM SIU, the GC Subrogation Department, GC Legal Staff, and GC Staff. + Review ERISA plan documents to determine whether the plan is a… more
- Zurich NA (Schaumburg, IL)
- …Assist in the identification of fraudulent billings by reporting suspicious activity to Special Investigations Unit . + Resolve escalated issues by exercising ... or more years of experience in the Critical Care Unit or Emergency Room or Medical Surgical Facility or...or more years of experience in the Critical Care Unit or Emergency Room or Medical Surgical Facility or… more
- Travelers Insurance Company (East Bridgewater, MA)
- …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 (Springfield, VA)
- …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
- USAA (St. Louis, MO)
- …and policy provisions. + Review claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable. + Maintain ... we treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Sr. Field Auto Appraiser, you will… more
- MTA (New York, NY)
- …the development of routine quality assurance evaluations in collaboration with Security Special Investigations unit (s), MTA Legal, Labor relations, the ... Director, Quality Assurance Job ID: 13522 Business Unit : MTA Headquarters Location: New York, NY, United States Regular/Temporary: Regular Department: HQ Office of… more
- Travelers Insurance Company (Richmond, VA)
- …other internal and external customers/business partners. + Recognizes when to refer claims to Special Investigations Unit and/or Subrogation Unit . + ... Performs administrative functions such as expense accounts, time off reporting, etc. as required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, WC, GL and other areas of the… more
- Sedgwick (Frisco, TX)
- …with internal departments. + Provides referrals to legal, utilization review, pharmacy, and Special Investigations Unit (SIU) as appropriate and coordinates ... independent medical examinations. + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** Education and Licensing High school diploma or GED required. Associate's degree from an accredited college or university… more