- Prime Therapeutics (Hartford, CT)
- …a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Special Investigations Unit ( SIU ) Investigator - Remote **Job ... Description** The Special Investigations Unit ( SIU ) Investigator is responsible for conducting standard investigations of potential pharmacy, member,… more
- The Cigna Group (Bloomfield, CT)
- **Fraud Senior Advisor - Special Investigations Unit ( SIU ) Matter Resolution** Our organization is a leader in healthcare services, committed to ... of accountability and collaboration. **Position Overview** The Fraud Senior Advisor - Special Investigations Unit ( SIU ) Matter Resolution plays a… more
- CVS Health (Hartford, CT)
- …seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ), dedicated to a specific self-funded plan ... sponsor. 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
- CVS Health (Hartford, CT)
- …The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for ... medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company… more
- CVS Health (Hartford, CT)
- …position can be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit ( SIU ) is looking for an analytically ... and reviewing incoming referrals and leads to determine if additional investigations are warranted. **Key Responsibilities** + Identify, research, analyze and… more
- The Cigna Group (Bloomfield, CT)
- …clinical support to Cigna Healthcare matrix partners including National Ancillary Contracting, Special Investigations Unit , Customer Experience and Product + ... Provides guidance and acts as a mentor for Medical Management leadership **Key Competencies:** + Strategic Mindset + Clinical Acumen + Drives Results + Ensures Accountability + Collaborates + Business Insight + Courage + Communicates Effectively… more
- Molina Healthcare (CT)
- …hospital, clinic settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical… more
- CVS Health (Hartford, CT)
- …are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This is ... datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider… more