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
- ...your job application. Healthcare Fraud Shield will not contact... ...Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES... ...Work with SIU Team (Clinical... ...discuss to make appropriate coding determinations as... ...development initiatives ~ Remote work eligible...Remote workFraudFull timeFlexible hours
- Centene Corporation is seeking a seasoned Health Care Fraud Investigator to support a remote SIU team across the continental US. You will guide investigations... ...to mitigate risks. The role requires 5+ years in healthcare fraud investigations, knowledge of government programs...Remote jobFraudFlexible 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- ...TN corporate office with remote work flexibility Travel... ...to 25% The Compliance Investigator is responsible for conducting... ...safety, privacy, and healthcare operations across one of the... ...compliance Billing and coding concerns Fraud, waste, and abuse risks...Remote workFraudWork at office
$107.9k - $172.64k
...is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical... ...health care fraud, waste, and abuse. This... ...effective leadership for a remote workforce, including... ..., including the Code of Conduct, Compliance... ...interpretation of complex healthcare claims data to...Remote workFraudWork at officeLocal areaFlexible hours2 days per week$64k - $68k
...We offer remote work opportunities (AK, AR, AZ, CO... ...adjudicated DOD background investigation for this position.... ...reporting of suspected fraud, waste and abuse (FWA)... ...Affairs (VA), the Healthcare Finance Administration... ...HCPCS, DRG and Revenue Code coding conventions. Knowledge...Remote workFraudContract workTemporary workFor subcontractorInterim roleLocal areaShift work- ...Estágios e Treinamentos seeks a Medicaid Fraud Investigator to join its Special Investigations Unit. This role focuses on identifying healthcare fraud, conducting audits, data analysis... ...skills, and MS Office proficiency. Remote work from the Chicago area is preferred...Remote jobFraud
- ...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 workFraudHome office
- ...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
- ...delivers on our promises. Position Summary:The SIU Investigator will conduct field as well as desk... ...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 workFraudFull timeWork experience placementWork at office
$78.9k
...DescriptionThis position can be remote anywhere in the United States, however... ....We are seeking an experienced investigator to join our Special Investigations Unit (SIU). SIU is responsible for... ...investigating and deterring insurance fraud committed against our companies,...Remote workFraudWork at officeFlexible hours- ...Corporation is seeking a senior leader to direct SIU analytics, detection, and investigative analytics across healthcare programs. You will work with SIU leadership and... ...role requires 5+ years in healthcare analytics, fraud detection, SIU operations, and leadership of analytics...Fraud
- The SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit. This remote investigator will work from home and service the Miami-Dade County and surrounding areas...Remote jobFraudWork from home
$25 - $30 per hour
...Part-Time SIU/Claims Investigator For the past 28 years, Advantage Investigations has been the Nation... ..., Net-Sweep Investigations, Remote Controlled Surveillance, and more, we'... ...our clients time and money on insurance fraud cases. Advantage Investigations is...Remote workFraudBi-weekly payHourly payPart timeWork at officeFlexible hours- ...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
$25 - $50 per hour
...strategy & scheduling Paid travel for field investigations when required Job Summary The SIU Investigator conducts field and remote investigations involving insurance claims.... ...principles, compensability analysis, fraud indicators, and investigative documentation...Remote workFraudHourly payPart timeWork at officeHome officeFlexible hoursAfternoon shift$91.55k - $118.47k
...claims 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. ~ Dental... ...and AD&D coverages. Remote work is not available...Remote workFraudTemporary workFlexible hours- National General is seeking an experienced SIU Investigator to join our team. This role handles highly complex, multi-discipline claims including... ...represented and large losses, with emphasis on potential fraud. The investigator conducts background searches, site...Remote jobFraud
$46.99k - $122.4k
...CVS Health is seeking an SIU Investigator for Meritain Health’s Network Cost Management team to combat healthcare fraud and abuse. You will conduct investigations, coordinate with law enforcement, and document activity while following regulatory requirements and company...FraudFull time- ...Special Investigation Unit Investigator Delta Group is a privately held... ...experience leading national carrier fraud divisions, state fraud... ...personnel, insurance carrier SIU staff, law enforcement, and government... ...all applicable laws, legal codes, and governing agencies....Remote workFraudLocal area
- Kemper is seeking a remote SIU Investigator to conduct field and desk investigations of insurance claims from home in the Miami-Dade area, traveling as needed. Responsibilities include analysis, evidence development, and coordinating with NICB and law enforcement, with...Remote jobFraud
- ...We are seeking a Senior Healthcare Fraud Investigator to support our program integrity efforts through hands‑on investigation of potential fraud,... ...terminology knowledge and/or experience with CPT and ICD-10 coding. Additional Qualifications Proficiency with Microsoft...Remote workFraudWork at office
$62.1k - $92.7k
...directly to consumers. Job Description As a SIU Field Investigator responsibilities include investigating suspected fraud, conducting detailed case reviews, and handling... ..., Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident...FraudWork at officeWork from homeVisa sponsorshipWork visa$80.2k - $118.3k
...customers’ lives by making healthcare work better, is far from ordinary... ...of Premera’s Special Investigations Unit (SIU), the Investigator III leads... ...allegations of external fraud, waste, and abuse (FWA). This... ...Healthcare Common Procedure Coding System (HCPCS).Strong...FraudWork 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
- Kemper Corporation in Dallas, TX is seeking a SIU Investigator to conduct field and desk investigations of insurance claims. This remote role supports the Downers Grove area with... ...agencies, and prepare formal reports for fraud investigations. The role requires knowledge...Remote jobFraud
- ...Description The Nurse Investigator works as part of the... ...Investigations Unit (SIU) team, detecting and investigating... ...suspected fraud, waste, and abuse (FWA... ...of clinical reviews, coding and documentation, conducting... ..., and resolve healthcare fraud, waste, and abuse...FraudContract workWork at office
$70.1k - $126.2k
...flexibility. This is a remote role anywhere... ...to team members who investigate and remediate compliance and fraud, waste, and abuse related... ...casework and other SIU activities.... ...preferred. 5+ years Healthcare fraud-related investigations... ...and medical claims coding preferred preferred...Remote workFraudFull timePart timeWork at officeFlexible hours- RGP is seeking an experienced SIU Clinical Investigator / Healthcare Compliance Professional to support a growing Special Investigations Unit. You will... ...compliance reviews of medical records to identify potential fraud, waste, abuse, and billing irregularities, serving as a...Fraud
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