- Prime Therapeutics (Springfield, IL)
- …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
- CVS Health (Springfield, IL)
- …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 (Springfield, IL)
- …all with heart, each and every day. **Position Summary** - Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare ... to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. -… more
- CVS Health (Springfield, IL)
- …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
- Capital One (Chicago, IL)
- AML Sr Investigator II- SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized investigations ... (SME)** will work closely with key stakeholders in the SIU and outside of the SIU when...+ Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in… 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 (Chicago, IL)
- …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
- CVS Health (Springfield, IL)
- …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