- Molina Healthcare (Bowling Green, KY)
- **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 on… more
- Molina Healthcare (KY)
- …responsible to lead a small team of investigators and provide oversight on daily investigative activities as a back-up to the SIU Manager. This position will be ... complete and signed-off + Provide guidance to investigators as needed on investigative techniques, tools, or strategy. + Effectively investigate and manage complex… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... providers. This position uses information from a tip, member benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely turn around. This position… more
- CVS Health (Frankfort, KY)
- …are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a specific self-funded plan ... evidence in support of case investigations. **Required Qualifications** + 3-5 years investigative experience in the area of healthcare fraud, waste and abuse. +… more
- Molina Healthcare (Louisville, KY)
- …the audit process and provide recommendations for system enhancement to augment investigative outcomes and performance. + Accurately tracks, reports, and follows up ... Association + Active and unrestricted Accredited Health Care Fraud Investigator (AHFI) designation or Certified Fraud Examiner (CFE) **Preferred Education**… more
- USAA (Louisville, KY)
- …makes us special and impactful. **The Opportunity** As a dedicated **Manager, Special Investigations Unit for Property & Casualty** , you will be responsible ... investigative tools and techniques to guide and coach special investigators. + Proven ability to build and maintain...**What sets you apart:** + 2+ years of SIU investigator experience. + Current or prior SIU leadership experience… more