Remote SIU Investigator: Healthcare Coding & Fraud
Healthcare Fraud Shield
- Remote job
A leading company in healthcare fraud prevention is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical records, documenting findings, and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a minimum of one year of coding experience. Join a dedicated team committed to preventing healthcare fraud and ensuring payment integrity. #J-18808-Ljbffr Healthcare Fraud Shield
- ...Investigating allegations of potential healthcare fraud and abuse, the full-time SIU Investigator will conduct investigations, perform data... ...detailed reports while working remotely, preferably from Ohio. Key... ...Ability to understand and analyze healthcare claims and coding...Remote workFraudFull time
- ...your job application. Healthcare Fraud Shield will not contact... ...Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES... ...Work with SIU Team (Clinical Reviewers... ...to make appropriate coding determinations as needed... ...initiatives Remote work eligible REMOTE WORK...Remote workFraudFull timeFlexible hours
- ...Providing investigative support for special investigation unit (SIU) activities, the full-time Healthcare Investigator will focus on... ...investigation of healthcare fraud, waste, and abuse (... ...), while working remotely to analyze... ...ensure compliance with coding and billing guidelines...Remote workFraudFull time
- Centene Corp. is seeking a full-time SIU Investigator to work remotely in California. This role involves investigating healthcare fraud allegations, performing data mining, and analyzing claims to identify potential abuse. Applicants should possess a Bachelor’s degree...Remote jobFraudFull time
- Molina Healthcare in the United States seeks an investigator to support the SIU's medical provider coding fraud investigations. You will re-evaluate post-payment claims against records, review CPT guidelines, and prepare clinical summaries to facilitate referrals. This...Fraud
$56.2k - $101k
Centene Corporation is seeking a qualified candidate for a remote role focused on investigating healthcare fraud. You will conduct thorough investigations into potential fraud, waste, and abuse, develop analytical reports, and work collaboratively with Health Plans. To...Remote jobFraud$19.64 - $42.55 per hour
...JOB DESCRIPTION Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves... ...the Internal Job Board. Molina Healthcare offers a competitive benefits and...Remote workFraudHourly payContract workWork experience placementWork at officeLocal area$56.2k - $101k
Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations... ...time off plus holidays Flexible approach to work with remote, hybrid, field or office schedules Actual pay will...Remote workFraudWork at officeFlexible hours$56.2k - $101k
Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations... ...time off plus holidays Flexible approach to work with remote, hybrid, field, or office schedules Additional...Remote workFraudWork at officeFlexible hours$21.82 - $42.55 per hour
Molina Healthcare is seeking candidates for a role focused on investigating medical provider coding fraud, waste, and abuse (FWA). The position requires independent assessment of medical claims, adherence to regulatory standards, and effective communication within teams...FraudHourly pay- ...Clinical Certified Coder to support fraud detection and investigations in the Special Investigations Unit.... ...years of relevant experience and AAPC coding certification are required. This... ...and integrity in handling sensitive healthcare information. #J-18808-Ljbffr MetroPlusHealthFraud
- ...Seeking a full-time remote Healthcare Fraud Investigator, the successful candidate will manage complex investigations into healthcare fraud, waste, and... ...transactions Provide expert guidance and training to other SIU Investigators and contribute to policy development...Remote workFraudFull time
$53.5k - $77.8k
...Siu Investigator This position is listed on behalf of a partner company, who manages all applications... ...to identify and prevent insurance fraud while supporting fair claim outcomes.... ...documentation and strong communication. This remote opportunity provides a collaborative...Remote workFraud$28.1 - $42.15 per hour
.../ Days Hybrid or Remote Join a mission‑driven... ...miss, analyze coding patterns with accuracy... ...integrity in healthcare claims, this is your... ...Audit and the Fraud, Waste and Abuse (... ...FWA) Committee for investigations and provider communication... ...and ensures the SIU processes and...Remote workFraudDaily paidFull timeTemporary workFlexible hours$70k - $117k
Kemper Corporation is hiring a SIU Investigator III in Miami, Florida. This role focuses on investigating complex, suspicious claims and coordinating... ..., and proficiency in Microsoft products. The position is remote but requires residency in Miami Dade County for assignments....Remote jobFraud$19.64 - $42.55 per hour
...Job Summary Provides investigative support for special investigation unit (SIU) activities.... ...related to health care fraud, waste, and abuse (FWA)... ...to national and local coding and billing guidelines... ...contracting and credentialing, healthcare services, member services...Remote workFraudHourly payContract workWork experience placementWork at officeLocal area$30 - $35 per hour
VRC Investigations is seeking experienced and motivated Part-Time SIU Investigators in New Orleans, Louisiana. These roles allow for work from home or on-site, requiring... ...for investigations into potential insurance fraud. The ideal candidates will have relevant experience...Remote jobFraudHourly payPart timeWork from home- Safepoint MGA, LLC is seeking a highly motivated SIU Examiner to work remotely in Louisiana. This role requires expertise in handling claims fraud investigations, including analysis and recommendation of actions. The examiner will conduct interviews, coordinate with SIU...Remote jobFraud
$53.5k - $77.8k
...SIU Investigator At Allstate, great things happen when our people work together to protect families and their belongings from life's uncertainties... ...to the Special Investigation Unit (SIU) for potential fraud. The role conducts site inspections, including body shops,...Remote workFraudWork from homeWork visa$70k - $117k
Kemper Corporation is hiring a SIU Investigator III responsible for investigating complex and suspicious... ...and investigative skills. This remote position primarily targets candidates residing... ...contacts, and collaborate with state fraud bureaus. A minimum of four years'...Remote jobFraudWork at office- ...Special Investigations Unit (Siu) Desk Investigator At AssuranceAmerica, we are more than a unique... ...investigations involving suspicions of insurance fraud related to the application of... ...standards, and professional codes of conduct to maintain trust and credibility...Remote workFraudContract workWork at officeRelocation package
$30 - $35 per hour
VRC Investigations is seeking experienced Part-Time SIU Investigators to join its team in Las Vegas, Nevada. You will investigate potential insurance fraud, conduct interviews, and document findings in detailed reports. The role requires excellent communication, analytical...Remote jobFraudHourly payPart time$80.74k - $121.11k
...high-quality, affordable healthcare. Serving nearly 2... ...Job Summary The Investigator II is an essential team... ...Special Investigation Unit (SIU) responsible for... ...investigations related to fraud, waste, and abuse, and... ...contract provisions, coding rules, coverage rules,...FraudContract workWork at officeWork from homeFlexible hours- 4004 Aetna Medicaid Administrators is seeking a SIU Investigator based in Oklahoma to investigate allegations of Medicaid healthcare fraud. The role involves managing a caseload, conducting interviews, and using data analytics to identify suspicious activities. Applicants...Fraud
- The SIU Investigator will conduct field as well as desk investigations of insurance claims referred... ...Special Investigator will function as a remote investigator working from her/his... ...SIU contacts, the Department of Insurance Fraud Division, NICB, and various law enforcement...Remote workFraudWork experience placementWork at office
- ...Health and Hospital System (PHHS) is looking for a Clinical SIU Investigator to implement an effective compliance program for the Parkland... .... This role involves conducting thorough investigations into fraud, waste, and abuse within Medicaid and CHIP. The ideal candidate...Fraud
- Health Alliance Plan is seeking a Special Investigative Unit (SIU) Investigator in Troy, Michigan. The... ...audits, and analyze data to support fraud prevention efforts. This role requires... ...degree and significant experience in healthcare investigations or related fields. Certifications...Fraud
- 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 jobFraudHome office
- Chicago, IL (Remote) Des Plaines, IL 60018, USA Description... ...for indicators of fraud or suspicious activity... ...and triage the SIU’s cases based on risk,... ...of complex, high-value investigations from intake through resolution... ...of plans to fit your healthcare needs. Employer-Paid...Remote jobFraudTemporary workWork at officeFlexible hours
$70k - $117k
## SIU Expert InvestigatorApplylocations: Remote-FL: Miami, Floridatime type: Full timeposted on: Posted Yesterdayjob... ...****Position Summary:**The SIU Investigator III is responsible for the investigation... ...that may contain elements of fraud or claims otherwise deemed...Remote workFraudTemporary workWork at officeLocal area
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