- USAA (San Diego, CA)
- …and policy provisions. + Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable. + Maintains ... 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
- Centene Corporation (Columbus, OH)
- …and federal requirements. + Will oversee Program Integrity Program, the Complaint, Grievance, Special Investigations Unit , and the fair hearing process, and ... ensure that Fraud, Waste and Abuse is reported in accordance with state and federal guidelines. + Will report directly to the Plan CEO and Board of Directors. + Will serve as an account manager to the Department of Healthcare and Family services to facilitate… more
- Molina Healthcare (Idaho Falls, ID)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions… more
- Molina Healthcare (Covington, KY)
- …accountability for compliance by overseeing, follow-up and resolution of 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… more
- CVS Health (Charleston, WV)
- …Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance, Medicaid Investigations , MCO Medicaid FWA Unit in the following States: **Texas, ... Leads a team in the planning and execution of investigations of acts of healthcare fraud and abuse by...and development needs. Assesses training needs and works with SIU Director on development plans for team members. Develops… more
- Allied Universal (Billings, MT)
- …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
- Customs and Border Protection (Grand Island, NY)
- …US Customs and Border Protection, US Border Patrol, Buffalo Sector, Sector Intelligence Unit ( SIU ), located in Grand Island, NY. Additional selections may be ... 5 USC 8331 (6c) and 8412 (d). Duties and responsibilities include: Leading a unit or team of Border Patrol Agents capable of anticipating, targeting, detecting, and… more
- NJM Insurance (Trenton, NJ)
- …injured workers, medical providers, the NJM Medical Claims Services Department, the NJM Special Investigation Unit , the NJM WC Legal Staff, and other departments ... Evaluate the claim for potential fraud indicators and escalates the file to SIU , as appropriate + Recognize and investigate subrogation opportunity and refer to NJM… more