Remote SIU Investigator: Healthcare Coding & Fraud
Healthcare Fraud Shield
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 is seeking a Clinical Coder/Fraud Investigator to join our SIU team at headquarters. You will analyze medical records, abstract CPT/HCPCS/ICD-10 codes, and prepare reports while maintaining privacy... ...work independently. Remote work eligibility is available...Remote jobFraud
- SIU Clinical Investigator Department: SIU Employment Type: Full Time Location... ...Headquarters Description Healthcare Fraud Shield, a leader in... ...discuss to make appropriate coding determinations as needed).... ...development initiatives Remote work eligible REMOTE WORK...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
- Healthcare Fraud Shield is seeking a CPC-certified Medical Coding Specialist to join our SIU team. You will review medical records, abstract CPT/HCPCS/Revenue Codes, DRG and ICD... ...provide subject matter expertise for clients. Remote work eligible; 401(k), generous PTO, and...Remote jobFraud
$45.39k - $106.2k
...DESCRIPTION Provides support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves... ...the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation...Remote workFraudFull timeContract workWork at officeLocal area$56.2k - $101k
...flexibility. Please note: this is a remote role with preference on... ...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: $56,200.0...Remote workFraudFull timePart timeWork at officeFlexible hours- ...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
- ...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
$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$40.85k - $88.5k
...Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible... ...related to health care fraud, waste, and abuse (FWA)... ...to national and local coding and billing guidelines... ...contracting and credentialing, healthcare services, member...Remote workFraudFull timeContract workWork at officeLocal area- ...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
$77.12k - $138.81k
...spouses. USAA roles may offer remote or hybrid flexibility for... ...potential fraudulent claims by investigating questionable, suspect claims... ...compliance with state insurance fraud-related laws and regulations... ...adjusting experience, or P&C SIU/Fraud Investigation experience...Remote workFraudFull timeH1bLocal area- ...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
$28.1 - $42.15 per hour
.../ Days Hybrid or Remote Join a mission‑driven... ...miss, analyze coding patterns with accuracy... ...integrity in healthcare claims, this is your... ...Audit and the Fraud, Waste and Abuse (... ...FWA) Committee for investigations and provider communication... ...and ensures the SIU processes and...Remote workFraudDaily paidFull timeTemporary workFlexible hours$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- VRC Investigations seeks experienced SIU investigators to support multi-line insurance fraud investigations. Work from home options are available with a hybrid model and travel within the advertised city and state is required. You will interview insureds and witnesses,...Remote jobFraudWork from home
- 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 - $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- ...Job TitleProvides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA).Essential Job DutiesIndependently... ..., and present findings.Molina Healthcare offers a competitive benefits and compensation...Remote workFraudContract workWork at officeLocal area
$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- Command Investigations seeks an experienced SIU Investigator to join our Operations team. This embedded role conducts claim/file evaluations to detect fraud, prepares SIU reports, and collects evidence suitable for court presentation. The ideal candidate understands commercial...Remote jobFraud
- ...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
- 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
- ...Corporation in Miami, Florida is seeking a SIU Investigator to conduct field and desk investigations of insurance claims within a remote role servicing the Miami-Dade County area. You will gather facts, coordinate with fraud units and law enforcement, prepare reports for...Remote jobFraud
- 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
$60.2k - $107.4k
...flexibility to work remotely as you take on... ...Collaborate with clinical coding consultant to... ...of aberrances (SIU only) Gather all... ...behavior through an Investigation Summary and... ...in a FWA / SIU or Fraud investigations role... ...(CFE), Accredited Healthcare Fraud Investigator...Remote workFraudMinimum wageFull timeWork experience placementLocal area$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- ...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
- ...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
- ...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
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