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 Reviewers... ...to make appropriate coding determinations as needed... ...initiatives Remote work eligible REMOTE WORK...Remote workFraudFull timeFlexible hours
- A leading company in healthcare fraud prevention is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient... ..., and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification...Remote jobFraudFull time
$63.65k - $92.57k
...to be within the healthcare industry. As a member... ...much more. The Fraud Analyst is building... ...Health Plan's Special Investigations Unit; this role... ...analytics for the SIU to find fraud... ...knowledge of healthcare coding conventions, fraud... ...0 PM Eastern Time Remote workspace...Remote workFraudFull timeContract workWork at officeMonday to FridayFlexible hoursShift work$56.2k - $101k
...partner is looking for a SIU Investigator based in the United... ...focused on protecting healthcare programs by investigating potential fraud, waste, and abuse (FWA)... ...information, financial records, coding documentation, and... ...that may include remote, hybrid, field, or office...Remote workFraudWork at officeFlexible hours- ...Compliance Investigator The Compliance Investigator is responsible... ...corporate office, with remote work capability. We are... ...safety, privacy, and healthcare operations across one of the... ...compliance Billing and coding concerns Fraud, waste, and abuse risks...Remote workFraudWork at office
- ...Job DescriptionProvides support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves... ...apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and...Remote workFraudContract workWork at officeLocal area
- ...Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims data... ...fraud patterns Knowledge of healthcare coding, billing, and documentation standards...Remote workFraudFull time
$56.2k - $101k
...flexibility. Please note: this is a remote role with preference on... ...residing within Ohio.Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning... ...analyze health care claims and coding required. Pay Range: $56,200.00 -...Remote workFraudFull timePart timeWork at officeFlexible hours- Optum is seeking a Coding Consultant to investigate and resolve healthcare fraud and abuse, using CPT coding knowledge to document findings and guide investigations. The role offers telecommuting from anywhere in the United States and targets 8:00am-5:00pm hours with occasional...Remote jobFraud
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and provider abuse using CPT coding guidance. You will mentor investigators, review claims against medical records, and coordinate with internal and external stakeholders to ensure...Remote jobFraud
$79.56k - $115.72k
...an exciting place to be within the healthcare industry. As a member of Mass General... ...Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving... ...generally 8:30-5:00 PM Eastern Time Remote workspace requirements, including privacy...Remote workFraudFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work$79.56k - $115.72k
...an exciting place to be within the healthcare industry. As a member of Mass General... ...Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving... ...generally 8:30-5:00 PM Eastern Time Remote workspace requirements, including...Remote workFraudFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work- ...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 an experienced Healthcare Investigator to join its Special Investigations Unit (SIU). You will conduct investigations of fraud, waste, and abuse in Medicare... ...adjudication. This remote role requires strong... ..., interview skills, CPT code knowledge, and the ability...Remote workFraud
$25 - $29 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- ...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
$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$46.99k - $112.2k
...Senior Investigator, Aetna Special Investigations Unit We're building... ...known or suspected acts of healthcare fraud and abuse. This position... ...proactive data mining using SIU Tools to identify aberrant billing... ...knowledge of medical coding; CPT, HCPCS, ICD10 ~ Proficient...Remote workFraudHourly payFull timeTemporary workWork at officeLocal area- ...happen. Job Summary A Special Investigations Unit (SIU) Desk Investigator within an insurance... ...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
$80.99k - $121.49k
...high-quality, affordable healthcare. Serving nearly 2... ...Health. Job Summary The Investigator II is an essential team... ...Investigation Unit (SIU) responsible for leading... ...related to fraud, waste, and abuse, and... ...contract provisions, coding rules, coverage rules,...FraudContract workWork at officeWork from homeFlexible hours$65k - $88.6k
...Healthcare Investigator Humana is looking for an experienced Healthcare... ...passion for combating Fraud, Waste, and Abuse in... ...to join Humana's SIU. The Fraud and Waste... ...record reviews CPT code experience Experience... ...: While this is a remote position, occasional travel...Remote workFraudTemporary workWork at officeLocal areaWork from homeHome office$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 (mid-level), you will work within... ...activity in compliance with state insurance fraud-related laws and regulations and...Remote workFraudHourly payFull timeH1bWork at officeLocal area- Premera Blue Cross is hiring an Investigator III in our Hybrid SIU team. You will lead medium to high complexity fraud cases from start to finish, analyze claims data, and coordinate... ...enforcement as needed. The role requires healthcare fraud investigation experience, strong...Fraud
$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- Medica in Minnetonka, MN is seeking an SIU Investigator IV to lead advanced fraud, waste, and abuse investigations involving members, providers, and employees. You will manage complex cases, review evidence from multiple sources, and guide actions that support legal or...Fraud
- ...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
- A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing... ...a minimum of 5 years in fraud investigations. This is a remote role with a strong preference for residents of New York....Remote workFraud
- ...The University of Massachusetts Medical School seeks a Fraud Investigator II in Healthcare to combat fraud and abuse within the Medicaid program. This... ...in Microsoft Office are essential. The position is remote, allowing for flexible work arrangements. #J-18808-LjbffrRemote workFraudWork at officeFlexible hours
$56.2k - $101k
...Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals,... ...that may present risks to healthcare programs and recommend... ...medical records, billing and coding documentation, provider... ...flexible approach to work with remote, hybrid, field or office...Remote workFraudFull timePart timeWork at officeFlexible hours- ...Job Opportunity Council Capital is a healthcare-focused private equity firm based in... ...analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid... ...but you will not manage anyone. Strong investigators here come from healthcare payer/vendor...Remote workFraud
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