• Investigator , Special…

    Molina Healthcare (Fort Worth, TX)
    **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 (11/24/25)
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  • Lead Investigator , Special…

    Molina Healthcare (Houston, TX)
    …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 (11/21/25)
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  • Investigator , Coding Special…

    Molina Healthcare (Dallas, TX)
    **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
    Molina Healthcare (11/20/25)
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  • Senior Investigator , Special…

    CVS Health (Austin, TX)
    …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
    CVS Health (11/19/25)
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  • Claims Investigator

    Allied Solutions (Plano, TX)
    …or Analyst. The key responsibilities of this job are both administrative and investigative . The ability to understand and apply the basic coverage aspects of ... volume of incoming claim assignments, evaluate coverage through an investigative set of online tools and databases, as well...accident report providers to match the damage on a unit of collateral to a corresponding insurance policy; +… more
    Allied Solutions (10/12/25)
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