- CVS Health (Oklahoma City, OK)
- …of Oklahoma. Must be willing to work CDT schedule. - Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud ... to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. -… more
- The Robison Group (Brooklyn, NY)
- …reading and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire… more
- USAA (Louisville, KY)
- …truly makes us special and impactful. **The Opportunity** As a dedicated **Manager, Special Investigations Unit for Property & Casualty** , you will be ... to demonstrate monthly productivity and cycle time outcomes from investigations assigned to the SIU team. +...teams. **What sets you apart:** + 2+ years of SIU investigator experience. + Current or prior… more
- Humana (Dayton, OH)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... Department of Medicaid (ODM) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in Ohio to increase… more
- Humana (Tallahassee, FL)
- …help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Senior Fraud and ... **Use your skills to make an impact** **WORK STYLE:** Remote , work at home. While this is a ...years of relevant work experience in Fraud & Abuse Investigations required + At least 2 years of healthcare… more
- Molina Healthcare (Ann Arbor, MI)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including Microsoft Word (edit/save… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Supervisor - Special Investigations Unit Clinical Location: Hybrid | Eagan, Minnesota ... This position works under the direction of the Manager, Operational Risk Management ( SIU ). This position ensures SIU department objectives are being met… more
- USAA (Omaha, NE)
- …makes us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). This is a Desk position. Within defined guidelines and ... and regulations and policies and procedures. **This role is remote eligible. However,** **you need to live in a...SIU experience conducting low to complex PNC fraud investigations OR a combination of Claims and Law Enforcement… more
- Centene Corporation (Columbus, OH)
- …including a fresh perspective on workplace flexibility. **Please note: this is a remote position, however, candidates who reside in the state of Ohio are highly ... and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud… more
- Molina Healthcare (Macon, GA)
- **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
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