Senior SIU Clinical Investigator - Remote Forensic Auditor
Oscar Health Insurance
New York, NY
- Remote job
Oscar Health Insurance is seeking a Senior Analyst, SIU Clinical Investigator to detect and audit aberrant billing patterns in claims and clinical documentation. You will review medical records to ensure alignment with guidelines and regulations, and identify schemes such as upcoding or unbundling. As a clinical SME, you will translate findings into education for Oscar teams and build evidentiary files for potential recovery or referrals. This is a remote role with NYC/Tempe office options. #J-18808-Ljbffr Oscar Health Insurance
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Senior SIU Clinical Investigator - Remote Forensic Auditor in New York, NY vacancy
- Oscar Health Insurance is seeking a Senior Analyst, SIU Clinical Investigator to detect and audit aberrant billing patterns in claims and clinical documentation... ...files for potential recovery or referrals. This is a remote role with NYC/Tempe office options. #J-18808-Ljbffr...Remote jobSeniorWork at office
$68.7k - $123.7k
...Senior Clinical Coding Auditor & Trainer-Remote The Senior Clinical Coding Auditor & Trainer will conduct audits of inpatient coding processes for Fiscal care and assist in development of training and audit tools. Location: The Senior Clinical Coding Auditor & Trainer...Remote jobSeniorFull timePart timeWork at officeFlexible hours- OpenAI is seeking a Technical Threat Investigator to protect our systems and users from sophisticated adversaries and model misuse. You will... ...safety improvements across OpenAI's ecosystem. The role is remote with regular in-person collaboration with our San Francisco headquarters...Remote workSeniorRelocation package
$60.2k - $107.4k
...have the flexibility to work remotely as you take on some tough challenges... ...are met Collaborate with clinical coding consultant to apply... ...validity of aberrances (SIU only) Gather all relevant... ...articulate behavior through an Investigation Summary and compliance package...Remote workSeniorMinimum wageFull timeWork experience placementLocal areaUnitedHealth Group
United States5 days ago- ...Senior Auditor Employment Type: Full Time, Mid-level CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-pay analyses...Remote workSeniorFull timeFlexible hours
Contact Government Services LLC
Chicago, IL5 days ago - Revolutional is seeking a Senior Forensic Analyst to lead end-to-end forensic evaluations of federal systems suspected of compromise.... ...interface directly with the intelligence community to inform investigations. The role requires a TS clearance, 7+ years of digital...Remote jobSeniorLocal area
- ...looking for a talented Coder or Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES Work with SIU Team (Clinical Reviewers,... ...initiatives ~ Remote work eligible REMOTE WORK... ...protected by applicable law. Seniority level ~ Seniority level...Remote workFull timeFlexible hours
Healthcare Fraud Shield
Wildwood, MO3 days ago $70.1k - $126.2k
...million members as a clinical professional on our Medical... ...the VP of Compliance Investigations this position assists... ...Investigations and/or senior management regarding... ...Legal, People Relations, SIU, Privacy, Finance, and... ...approach to work with remote, hybrid, field or...Remote workSeniorFull timePart timeWork at officeFlexible hours$176.94k - $196.6k
...shape the future of our industry. Role We are seeking a Senior Digital Forensic Investigator to serve as the operational manager of our Santa Clara... ...Area, including onsite imaging at corporate facilities and remote locations as needed. eDiscovery & Legal Support...Remote workSeniorHourly payFull timeWork at office2 days per week3 days per week$75.35k - $98.89k
...Oscar. We're hiring a Senior Analyst, Special Investigations Unit Clinical Investigator to join our SIU. Oscar is the first... ..., using forensic clinical expertise to... ...Location: This is a remote position, open to candidates... ...Professional Medical Auditor (CPMA), Certified Fraud...Remote workFull timeWork at officeWork from homeFlexible hours3 days per week$46.99k - $112.2k
...community at a time. Position Summary The Senior Investigator, Aetna Special Investigations Unit,... ...independently proactive data mining using SIU Tools to identify aberrant billing... ...scheme Research and prepare cases for both clinical and legal review Collaborate with...SeniorHourly payFull timeTemporary workWork at officeLocal area- Magnus Management Group LLC is seeking a Senior Forensic Accountant to support financial investigations involving fraud, money laundering, asset tracing, and federal benefit programs. The role focuses on forensic analyses to aid oversight organizations and law enforcement...Remote jobSenior
- Praescient Analytics is looking for a Senior Forensic Accountant to support complex financial investigations, particularly in identifying fraud and abuse in federal programs. The ideal candidate will have extensive experience in forensic accounting, with a strong focus...Remote jobSenior
$56.2k - $101k
...care, laboratory, etc. Provides investigative support to the Special Investigations Unit (SIU) related to coding and billing issues... ...abuse and fraud by utilizing clinical and coding expertise to analyze... ...flexible approach to work with remote, hybrid, field or office work schedules...Remote workFull timePart timeWork at officeFlexible hours- ...StatesCompany: HumanaPosted: 2026-08-05Humana Inc. is seeking a Senior Medical Coding Professional, Outpatient to lead coding-focused... ...document findings, support defensible audit determinations, and partner with clinical and analytics teams on audit strategies.#J-18808-LjbffrRemote workSenior
- Role Description Ardent is seeking a Senior Forensic Accountant to join our team. This is a remote position supporting complex financial investigations, fraud analysis, and the tracing of illicit financial activity across large-scale federal matters. The successful candidate...Remote workSeniorFull timeWork at officeLocal areaFlexible hours
Ardent
Remotea month ago - ...services for genomics, discovery pharmacology, forensics, CDMO, advanced material sciences and in the support of clinical studies.In over just 30 years, Eurofins... ...Viracor BioPharma Services team as a Senior Principal Investigator (SPI)/Principal Investigator (PI) (assigned...SeniorFull timeContract workWork experience placementWork at officeMonday to Friday
- Location: Remote (Occasional Travel May Be Required) Clearance: Ability to obtain and maintain a Public... ...Praescient Analytics is seeking an experienced Senior Forensic Accountant to support complex financial investigations involving fraud, waste, abuse, and mismanagement...Remote workSeniorWork at office
- ...Solution: HybridRelocation Eligibility: AvailableResponsibilitiesWhat You’ll DoWe are seeking a seasoned and strategic Senior Special Investigation Unit (SIU) Investigator to leadthe proactive detection, prevention, and resolution of fraudulent activities impacting our...SeniorH1bWork at office
- Centene Corporation seeks a Clinical Professional to lead compliance investigations in a diverse national organization. Your role will focus on conducting thorough investigations, analyzing compliance metrics, and collaborating with various departments to ensure adherence...Remote jobSeniorFlexible hours
$78.9k
...please visit our website: Job DescriptionThis position can be remote anywhere in the United States, however Texas is preferred.We are seeking an experienced investigator to join our Special Investigations Unit (SIU). SIU is responsible for detecting, investigating and...Remote workWork at officeFlexible hours- Centene Corporation in California is seeking a Clinical Compliance Investigator to oversee compliance investigations across business units. This role... ...offers competitive pay and a flexible working environment, including remote options. #J-18808-Ljbffr Centene CorporationRemote jobSeniorFlexible hours
- UnitedHealthcare is seeking a Senior Investigator to identify and prevent healthcare fraud, waste, and abuse. The role involves audits, claims... ...caseload, with potential field work. You will work within the SIU to triage, investigate, and resolve cases, collaborating with...Remote jobSenior
- A growing multi-site clinical research company is seeking a Principal Investigator to lead and coordinate clinical trial activities. The role includes ensuring the... ...plan. The position is full-time and offers a mid-senior level career path with various health benefits. #J...SeniorFull time
$77.12k - $147.39k
...military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military... .... The Opportunity As a dedicated SIU Investigator, within established guidelines and... ...resources, public records, and forensic tools. Make recommendations within defined...Remote workFull timeH1bWork at officeLocal areaUSAA
Colorado Springs, CO13 hours ago- ...Accountable for investigating claims suspected of fraud, the remote SIU Investigator will provide superior customer service while safeguarding the company and its insureds through thorough investigations and proactive claims review. Key responsibilities Conduct complete...Remote work
Virtual Vocations Inc
United States2 days ago $46.99k - $122.4k
...multi-disciplinary provider groups in a prepayment environment Investigates to prevent payment of fraudulent claims committed by insured's... ...providers, claimants, etc. Researches and prepares cases for clinical and legal review. Documents all appropriate case activity in case...SeniorHourly payFull timeTemporary workLocal areaHispanic Alliance for Career Enhancement
Louisiana, MO3 days ago- ...Safepoint Insurance is seeking an SIU Examiner in Louisiana to identify and handle all aspects of fraud investigations within the Claims Department. You will review SIU reported... ..., and the ability to work independently in a remote home-office environment. #J-18808-Ljbffr...Remote workHome office
Safepoint Insurance Company
Harahan, LA9 hours ago - ...Kemper Corporation is looking for an SIU Investigator for their Glendale, California location. This role supports insurance claims investigations through field and desk assignments, requiring strong communication skills and knowledge of claims processes. Ideal candidates...Remote work
Kemper
Glendale, CA2 days ago - ...Becker & Co Inc is seeking skilled and experienced Field Investigators for a fully remote, as needed position. This role involves investigating various... ...perform surveillance and Special Investigations Unit (SIU) assignments, ensuring adherence to instructions while maintaining...Remote workFlexible hours
J T Becker & Co Inc
Brooklyn, NY9 hours ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior SIU Clinical Investigator - Remote Forensic Auditor. Be the first to apply!
Related searches
- defense investigator New York, NY
- federal investigator New York, NY
- compliance investigator New York, NY
- background investigator New York, NY
- credit investigator New York, NY
- online investigator New York, NY
- siu investigator New York, NY
- federal background investigator New York, NY
- remote investigator New York, NY
- human rights investigator New York, NY