Clinical Fraud & Coding Lead, SIU
MetroPlus
MetroPlusHealth is looking for a Clinical Coder in New York. This role involves reviewing medical records and healthcare claims for compliance, conducting audits, and collaborating on fraud investigations. Candidates must have a minimum of 5 years' experience in healthcare fraud detection and a related bachelor’s degree. AAPC Coding certification is required, along with strong analytical and communication skills. Join a dedicated team that values integrity and trust in delivering quality healthcare services. #J-18808-Ljbffr
- CareSource is seeking an SIU Investigator Lead based in Kentucky. This pivotal role involves overseeing fraud investigations and managing regulatory communications with state and federal agencies. The ideal candidate will need to possess at least 10 years of experience...FraudRemote job
- CareSource is looking for an SIU Investigator Lead in Kentucky to act as a primary representative for regulatory bodies. Your role includes ensuring compliance, leading fraud investigations, and using data analytics to detect fraudulent activities. The ideal candidate will...Fraud
$83k - $132.8k
...Summary The Special Investigations Unit (SIU) Investigator Lead serves as the primary representative of... ..., identify and monitor emerging fraud, waste, and abuse (FWA) trends, and conduct... ...processes and data sources such as policies, coding guidelines, and regulations that...FraudRemote jobWork experience placementLive inWork at office- A healthcare company in New York is seeking a Fraud Investigator to conduct in-depth investigations of reported fraud. Responsibilities include mentoring other investigators, investigating Medicaid fraud cases, and maintaining relationships with law enforcement. Candidates...Fraud
- MetroPlusHealth in New York seeks a Clinical Certified Coder to support fraud detection and investigations in the Special Investigations Unit. The successful... .... A minimum of 5 years of relevant experience and AAPC coding certification are required. This role emphasizes strong...Fraud
- ...medical conversations, improving clinical documentation efficiencies... ...experienced and strategic Solution Lead - Revenue Cycle to join our... ...documentation accuracy, coding optimization, and revenue integrity... ...Protect yourself from recruitment fraud We are aware of individuals...FraudHourly payFull timeFlexible hours
- A national investigative services firm based in New York is seeking a meticulous SIU Investigator responsible for conducting thorough investigations into fraud and misconduct. The role includes scene recreations, document retrieval, wellness checks, and engaging with witnesses...Fraud
- ...Description ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical... ...company, specializing in surveillance and fraud detection. At the forefront, we provide... ...seeking a Special Unit Investigations (SIU) Field Investigator to conduct field...FraudCasual workLocal areaNight shift
- ...Consultant – Client Success is responsible for leading client relationships and delivering... ...lifecycle. This role partners closely with client SIU and claims organizations to develop... ...advisor, the Consultant integrates Verisk anti‑fraud solutions into client workflows, delivers...Fraud
- Job Description We are seeking a meticulous and experienced SIU Investigator to join our team. The ideal candidate will be responsible for conducting comprehensive investigations into potential fraud and misconduct. This role involves a variety of investigative tasks aimed...Fraud
- BCG Attorney Search is looking for an experienced SIU Litigation Attorney to join their team in New York, NY. The ideal candidate will... ...years of litigation experience and be passionate about combating fraud within the insurance sector. The role requires robust litigation...Fraud
- ...investigative services for insurance claims including workers' compensation and fraud. The ideal candidates should possess strong investigative techniques and must be able to conduct surveillance, complete SIU investigations, and communicate effectively with case managers while...FraudFlexible hours
- ...This role involves investigating various insurance claims including fraud and liability, offering flexible hours for licensed candidates.... ...will perform surveillance and Special Investigations Unit (SIU) assignments, ensuring adherence to instructions while maintaining...FraudRemote jobFlexible hours
$67k - $79k
...and prevent fraudulent claims for Great American Insurance Group's SIU. This fully remote position allows for up to 30% business travel.... ...and has 3 to 6 years of experience in Criminal Investigation or Fraud Detection. The salary ranges from $67,000 to $79,000 and includes...FraudRemote job$25 - $30 per hour
Ethos in New York seeks a Special Unit Investigations (SIU) Field Investigator to conduct thorough field investigations, gather and analyze evidence related to insurance claims. Responsibilities include on-site accident investigations, interviewing witnesses, and drafting...FraudHourly pay- RELX INC is searching for an Engagement Manager in the United States to oversee the delivery of complex, contracted professional services to clients. The role demands strong project management skills, excellent communication abilities for interacting with clients and stakeholders...Fraud
$20 - $27 per hour
Join to apply for the SIU Investigator Bronx, NY role at ISG 2 days ago Be among the first 25 applicants This range is provided by ISG... ...services firm specializing in cost containment and anti-fraud related services. We are dedicated to maintaining the highest standards...FraudFull time$18 per hour
...Hunter Super Techs - TurnPoint is seeking a Shortage Control Lead in New York, NY, to combat theft and fraud in our retail store. This role involves engaging customers positively, maintaining a secure environment, and leading training in shortage reduction. Ideal candidates...FraudFlexible hours$180k - $300k
...is seeking an Associate with 3 to 5 years of experience in plaintiff-side securities litigation. The role involves major securities fraud class actions and demands strong brief-writing skills and strategic judgment. The firm offers a competitive compensation package ranging...Fraud$160k - $190k
...efforts. The ideal candidate has 5 years of experience in the credit space, strong analytical and communication skills, and a passion for fraud and identity topics. This position offers a competitive salary between $160,000 and $190,000 annually, plus equity and benefits. #J-...FraudRemote work- Job Overview A law firm seeks an SIU Litigation Attorney with at least four years of experience for its New York, NY office. The ideal candidate will have a strong interest in combating fraud within the insurance industry and possess robust litigation and investigative...FraudWork at office
- ...seeking a skilled Claims Manager. The role involves providing advice to policy holders on claims, investigating claims to identify fraud, and ensuring fair settlements. The ideal candidate will hold a NY Property and Casualty License and be proficient in EPIC. This role...Fraud
$120.8k - $169.1k
...Wisetack, Inc. seeks a Lead Merchant Risk Analyst to enhance fraud detection processes in a rapidly growing fintech environment. You will lead the analysis of risk across the merchant lifecycle while developing scalable monitoring systems for effective decision-making....Fraud$230k - $250k
...Manager to scale alliance integrations for delivering top-tier fraud prevention products to U.S. financial institutions. In this remote... ...role, you will manage partnerships, execute growth plans, and lead QBRs while collaborating extensively with other teams. The ideal...FraudRemote work- A leading crypto company is seeking a Fraud & Risk Lead to oversee fraud operations for its credit card program. This role entails real-time monitoring, strategic fraud detection, and collaboration with engineering teams to enhance fraud prevention mechanisms. The ideal...Fraud
- Plaid is seeking a Fraud Consulting Lead to enhance its retro-as-a-service and POC programs while driving adoption of fraud products across its data team and customers. You will manage end-to-end processes and collaborate closely with clients, ensuring they understand the...Fraud
- PowerToFly is seeking an Assistant Vice President in New York to join the External Fraud Risk Team. You will manage and enhance fraud rules, conduct analytics, and support fraud incident investigations to protect client data. This role demands 3-5 years of experience, strong...Fraud
- Estée Lauder Companies is seeking a Forensics Senior Manager to lead high-risk forensic investigations across the Americas, with a focus... ...have significant experience in forensic investigation and fraud prevention, alongside relevant educational qualifications. Excellent...Fraud
$115.4k - $192.3k
RELX INC is seeking a player/coach for its Fraud & Identity Solutions Consulting team. In this role, you will support pre-sales for top strategic clients in North America. Responsibilities include leading solution designs, client assessments, and team mentorship. Ideal...Fraud- ...A leading technology company in the United States is looking for a Staff Backend Engineer to join its dynamic engineering team. This pivotal... ...and developing innovative software solutions to combat identity fraud. The ideal candidate will have 8-12 years of software...Fraud
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Fraud & Coding Lead, SIU. Be the first to apply!
- clinical operations lead New York, NY
- clinical trial lead New York, NY
- clinical research lead New York, NY
- clinical lead New York, NY
- clinical team lead New York, NY
- lead nurse practitioner New York, NY
- product manager fraud New York, NY
- fraud consultant New York, NY
- fraud officer New York, NY
- fraud prevention New York, NY


