Healthcare SIU Investigator: Data, Interviews & FWA
Martin's Point Health Care Inc.
Martin's Point Health Care Inc. is seeking an experienced SIU Investigator to join our team. The role covers FWA investigations across our Generations Advantage and US Family Health Plan programs, with responsibilities from intake through resolution, including data analysis, medical record review, and interviews. You will help shape investigative standards in a growing SIU, partnering with multiple departments to ensure compliance and accurate overpayment determinations, while maintaining PHI #J-18808-Ljbffr Martin's Point Health Care Inc.
$75.58k - $93.37k
...5. Position Summary The SIU Investigator looks into suspected fraud, waste and abuse (FWA) by providers, suppliers... ...resolution. That includes data analysis, medical record review, interviews, overpayment recovery,... ...equity, Martin's Point Healthcare has established defined...DataRemote jobFull timeFor contractorsWork at officeLocal area- Molina Healthcare is seeking a skilled investigator specializing in medical provider coding fraud, waste, and abuse (FWA) within the SIU. You will re-evaluate claims using CPT coding knowledge and applicable federal/state regulations, reviewing post-pay claims against records...Suggested
$70k - $90k
Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency... .... 5-8 years of related FWA investigative experience... ...), Certified Forensic Interviewer (CFI), or Certified in...DataFull timeWork experience placementWork at officeImmediate startRemote workWork from home$56.2k - $101k
# SIU InvestigatorUnited States40 minutes agoID 50... ...fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical records,... ...data, medical records, interviews, data analytics, and other... ...that may present risks to healthcare programs and recommend...DataFull timePart timeH1bWork at officeRemote workFlexible hours- ...challenges of affordable healthcare continue to create new opportunities... ...) Responsibilities: The SIU Fraud Investigator is responsible for... ...fraud, waste, and abuse (FWA) involving providers,... ...medical record, and provider data; conducts interviews, field investigations,...DataFull timePart timeWork at officeFlexible hours
$74k - $91k
Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required... ...fraud, waste, and abuse. Conduct interviews or correspond with patients, providers...DataWork experience placementWork at officeRemote workWork from home- Molina Healthcare is seeking an SIU investigator to support medical provider coding fraud, waste and abuse investigations. You will re-evaluate claims, review records, and apply CPT coding knowledge within Molina policies and federal/state regulations. This role requires...Work at office
$32 - $38 per hour
...with Allied Universal® Compliance and Investigation Services. Allied Universal®... ...opportunities for claim investigators, SIU investigators, and surveillance investigators... ...and case managers, by means of data collection, interviews, research and collaboration with other...Data- ...things happen. Job Summary A Special Investigations Unit (SIU) Desk Investigator within an insurance... ...investigative assignments, including backgrounds, interviews, and Examinations Under Oath. The... ...in relevant software applications for data analysis and documentation. Knowledge...DataWork at officeRelocation package
- ...Centene Corporation is seeking an SIU Investigator in the United States to conduct fraud, waste, and abuse investigations using referrals, claims data, medical records, and interviews. You will prepare reports, coordinate with internal teams, and support program integrity...DataRemote work
- ...MJHS Health System is seeking a SIU Fraud Investigator to identify, investigate, and resolve fraud, waste, and abuse... ...candidate will review claims, encounter data, enrollment records, medical charts, and conduct interviews and audits as needed to mitigate losses and ensure...Data
- ...Elderplan is seeking a SIU Fraud Investigator in New York, NY to identify, investigate, and resolve fraud, waste, and abuse involving... ...claims, enrollment, medical records, and provider data, and conduct interviews and on-site audits when needed. You will prepare investigative...Data
- ...Corporation is seeking a Fraud, Waste, and Abuse Investigator in the United States to conduct investigations by reviewing referrals, claims data, medical records, and provider... ...resolution. The role requires 2+ years in healthcare investigations and a Bachelor's degree....Data
$60.2k - $107.4k
Senior Investigator Pharmacy At UnitedHealthcare,... ...and prevention of healthcare fraud, waste and abuse... ...will use claims data, applicable... ...include field work, interviews, and documentation... ...Investigations Unit's (SIU's) case tracking... ...waste and abuse (FWA) 2+ years of experience...DataFull timeTemporary workWork experience placementLocal areaRemote work$62.1k - $105.3k
...Description The Special Investigative Unit Senior Consultant... ...Investigative Unit (SIU) for potential fraud.... ...4) conducting witness interviews and social media searches... ...Enters SIU claim data information into multiple... ...HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North...DataContract workWork at officeWork from homeVisa sponsorshipWork visa- ...Allied Universal is hiring an SIU Investigator to independently investigate fraudulent insurance claims across workers’ compensation, general... ...property, and disability. The role requires strong documentation, data gathering, and collaboration with law enforcement and state...DataWeekend work
$65k - $88.6k
...for conducting comprehensive investigations of reported, alleged or... ...Responsibilities Analyze healthcare payment methodologies, billing... ...consumer experience. Use data analysis and performance metrics... ...aligned with CST or EST. Interview Format As part of our...DataFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- CGS Federal is seeking an ACE Investigator in New York, NY with hybrid/remote options... ...lead fraud investigations across healthcare, contracting, and grants, and coordinate... ..., preparing reports, conducting interviews, and performing data analyses to build evidence for...DataRemote job
- ...collections in a health care setting. Under supervision, you will verify data, code, and process third-party billing forms to maximize... ...training or equivalent experience; responsibilities include interviewing patients, contacting insurers, and following #J-18808-Ljbffr NYC...Data
- Lemonade, Inc. is seeking an experienced SIU Investigator to protect honest policyholders and combat sophisticated fraud networks. Join our Claims... ...investigations, dismantle fraud rings, and collaborate with Data Science to refine predictive models, all while maintaining...DataRemote job
$19.64 - $42.55 per hour
...Provides support for special investigation unit (SIU) activities specific to... ...coding fraud, waste and abuse (FWA). Investigates and resolves... ...work with large quantities of data. Ability to answer questions... ...and present findings. Molina Healthcare offers a competitive...DataRemote jobHourly payContract workWork experience placementWork at officeLocal area$55k - $60k
...moves, and challenging the status quo. We’re built as a lean, data-driven organization that relies on a common understanding of... ...alltime What you’re applying for We're looking for an experienced SIU Investigator to help protect honest policyholders and keep sophisticated...DataFull timeWork at officeRemote workVisa sponsorshipWork visa- Cotiviti is seeking an Investigator to scrutinize suspected healthcare fraud, waste, or abuse using data analysis. This is a remote, work-from-home role within the United States... .... The role requires 2+ years in healthcare FWA investigations, advanced Excel, and strong communication...DataRemote jobWork from home
- Cotiviti is seeking a Senior Investigator who will analyze data and conduct interviews to identify potential healthcare fraud, waste, and abuse. This remote role emphasizes Excel expertise and the ability to work across a post-pay Fraud Waste & Abuse team. Responsibilities...DataRemote job
- United Automobile Insurance Company is seeking an Insurance Fraud Investigator I (SIU) for remote work in the United States, focused on high-... ...investigations. The role involves field and desk investigations, data review, and collaboration with law enforcement and medical...DataRemote job
$28 - $32 per hour
Allied Universal is hiring a Claims Investigator to validate facts of loss for insurance claims through field investigations, claimant and witness interviews, documentation, and data interpretation. The role requires driving and residence in the posting state, with a pay...DataHourly pay- Allied Universal Compliance and Investigation Services is hiring an SIU Investigator to detect and investigate fraudulent insurance claims. The role requires... .... Responsibilities include independent investigation, data collection, documentation, and producing professional...Data
- ...Job Description Job Description Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level... ...: - Review, sort, and analyze data using computer software programs such... ...etc. - Assist conducting witness interviews and preparing written summaries. Qualifications...DataFull timeWork experience placementWork at officeLocal area
- ...The SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by... ...Completion of the NICB Basic and/or Advanced Academies and the Reid Interviewing and Interrogation Courses are desirable. Must have excellent...Work experience placementWork at officeRemote work
- An insurance claims investigation firm is seeking a Special Unit Investigations (SIU) Field Investigator to conduct field investigations and analyze evidence related... ...on-site accident investigations, conducting interviews, and writing detailed reports to support claims...
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