Healthcare FWA Investigator - SIU Analyst
Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Kansas City seeks a Fraud Investigator to identify potential fraud, waste, and abuse (FWA) and claim overpayments within its Special Investigations Unit. Assigned cases are generally of moderate complexity and work with limited oversight. You will perform risk assessments, analyze trends with data analytics, and prepare detailed reports for executives and regulators. Collaboration with multiple departments is required, and you may assist in coordinating subpoenas #J-18808-Ljbffr Blue Cross and Blue Shield of Kansas City
- Blue KC’s Special Investigations Unit seeks a Fraud Investigator to conduct reviews identifying fraud, waste and abuse, with cases of moderate complexity and limited oversight. You will perform risk assessments, use data analytics, monitor hotlines, coordinate subpoenas...Suggested
- Centene Corporation is seeking an Investigator to conduct fraud, waste, and abuse investigations... .... The role requires 2+ years in FWA investigations or related fields and a Bachelor... ...experience, with opportunities to impact healthcare #J-18808-Ljbffr Centene CorporationSuggestedRemote job
- ...Centene Management Company LLC is seeking a healthcare investigator to conduct fraud, waste, and abuse investigations across claims data, medical records, and provider information. You will prepare reports, refer cases, and coordinate with internal and external partners...Suggested
- ...Job Title Fraud Investigator Job Description Summary As part... ...Special Investigations Unit (SIU), the Fraud Investigator conducts... ...fraud, waste, and abuse (FWA) and claim overpayments. Assigned... ...(e.g., CMS, BCBSA), external healthcare anti-fraud workgroups, and...Suggested
$89.17k - $142.68k
...analytics partner to the Special Investigations Unit (SIU) and Payment Integrity... ..., dashboard development, healthcare claims expertise, and stakeholder... ...initiatives. The analyst develops reporting and analytical... ...), Fraud, Waste & Abuse (FWA), Payment Integrity, claims...SuggestedLocal area$56.2k - $101k
...Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical records, provider information... ...irregularities, and trends that may present risks to healthcare programs and recommend appropriate actions for further...Full timePart timeWork at officeRemote workFlexible hours- Centene Corporation is seeking a clinical compliance investigations professional to lead enterprise-wide investigations for all business units... ...standards. You will collaborate with Legal, People Relations, SIU, Privacy, Finance, and Operations to drive timely remediation...Remote job
- ...Corp. in the United States seeks a Fraud, Waste, and Abuse (FWA) Investigator to review referrals, claims data, medical records, and provider... ...a Bachelor’s degree in a related field and 2+ years in healthcare investigations or related audits; preferred AHFI, CFE, CPC,...Remote job
- 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 jobLocal area
$70.1k - $126.2k
...general direction of the VP of Compliance Investigations this position assists with the... ...departments, including Legal, People Relations, SIU, Privacy, Finance, and Business Operations... ...investigations in a regulated healthcare environment preferred. Experience collaborating...Full timePart timeWork at officeRemote workFlexible hours- CVS Health is seeking a Program Integrity Auditor to review medical and other healthcare records for proper coding and documentation, with focus on regulatory standards and potential fraud, waste or abuse. Responsibilities include audits across Medicaid lines and coordination...Full time
- ...to team goals. WE ARE LOOKING FOR SOMEONE.!!Who holds 4 years of experience as a consultant!Who holds consulting experience in US Healthcare Payer market!Who holds 2+ years’ experience in US Payer operations & US Payer system implementations!Who is experienced in...
- As a leading financial services and healthcare technology company based on revenue, SS&C is headquartered in Windsor, Connecticut, and... ...expertise, scale, and technology.Job DescriptionJob Title: HRIS Analyst - Workday Time TrackingLocations: Chicago, IL; Atlanta, GA;...Ongoing contractFull timeShift work
- ...Special Unit Investigations (Siu) Field Investigator Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights...Casual workLocal areaNight shift
- J T Becker & Co Inc is looking for skilled Field Investigators to join our team on an 'as needed' basis. This role offers flexible hours and... ...involves conducting various investigations such as surveillance and SIU assignments. The ideal candidate must possess a valid driver's...Flexible hours
- As a leading financial services and healthcare technology company based on revenue, SS&C is headquartered in Windsor, Connecticut, and... ...Will Make an Impact Act as a trusted, client-facing Business Analyst partnering closely with Product Managers and delivery teams to...Ongoing contractFull timeWork at office
- BJC HealthCare is hiring an entry-level Field Services Tech Analyst on-site at Barnes Jewish Hospital in Missouri. Weekend days or weekend evenings shifts are required; prior IT experience is not required, though helpful as an entry-level position on the Field Technology...Weekend workDay shiftAfternoon shift
- A leading healthcare provider in Shawnee, Kansas, seeks an Epic Clinical Analyst I & II responsible for application support and implementation. The role demands strong clinical knowledge, problem-solving abilities, and the capability to work with various healthcare settings...
- ...We’re a small, fast-moving healthcare data analytics company looking for a curious, detail-oriented Business Analyst to help turn the needs of our clients and internal teams... ...stakeholder questions, validate data, and investigate discrepancies — with support and code review...InternshipImmediate startRemote work
- ...A leading financial services and healthcare technology company is seeking an experienced Business Analyst to join their Kansas City or Denver team. This hybrid role involves collaborating with clients and stakeholders to develop new features for a Money Market portal,...
- ...Physician - Academic Rheumatologist and/or Investigator The University of Kansas Health System, Division of Allergy, Clinical Immunology... .... The University of Kansas Health System is the official healthcare provider for the Kansas City Chiefs, Kansas City Royals, KC...
- ...Corporation is seeking a seasoned professional to drive performance improvements and reduce risk across multiple product lines in healthcare and insurance. The role requires collaborating with stakeholders to identify problems, develop solutions, and implement processes...Remote job
$120k
As a leading financial services and healthcare technology company based on revenue, SS&C... ...technology.**Job Description****Business Analyst****Location(s)**: Denver, CO / Kansas... ...support analysis, validation, and issue investigation.* Ability to critically assess stakeholder...Temporary workWork experience placementCasual workWork at officeFlexible hours- A leading healthcare technology provider is looking for an experienced Clinical Imaging Analyst to support imaging systems across various markets. This remote contract role requires 3-7 years of experience in healthcare imaging systems, with expertise in tools like PACS...Remote jobContract work
- ...LLC is seeking a senior-level product leader to drive performance improvements and risk reduction across multiple product lines in healthcare and insurance. You will coordinate with diverse teams, manage change initiatives, and ensure on-time delivery of strategic...Remote job
- ...Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation... ...leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed...Full timeWork at officeLocal area
- ...The Healthcare Analytics role supports the Risk Adjustment Programs team by analyzing healthcare data to evaluate program performance,... ...solutions on ad‑hoc requests with little oversight by senior analysts. To be considered for this position, you must have: Bachelor’s...Live inRemote work
- ...biggest names in mission-critical, higher education, sports, healthcare, grocery, restaurant, and retail within the sectors we serve in... ...different here: Job Summary The IT Asset Management (ITAM) Analyst supports the lifecycle management of IT assets, with a primary...Casual workFlexible hours
$156.6k - $266.7k
...client-focused team and make a difference in your career! *This is a 1099 Independent Contractor position.* The Principal Investigator (PI) is responsible for conducting objective clinical research that generates independent, high quality and reproducible results...Temporary workFor contractorsWork at officeImmediate startFlexible hours- ...J T Becker & Co Inc is seeking skilled and experienced Field Investigators to join our team on an "as needed" basis. This role is perfect for a licensed investigator looking for flexible hours while conducting various types of investigations, including surveillance and...Flexible hours
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