SIU Investigator
Virtual Vocations Inc
To support healthcare fraud investigations, the full-time Minnesota Licensed SIU Investigator will conduct thorough investigations, analyze trends, and provide mentorship to investigative teams while working remotely. Key responsibilities: Perform root-cause and trend analysis to develop prevention strategies and recommendations Gather facts and create comprehensive Investigation Summaries and compliance packages Provide case direction and mentorship to investigators, ensuring adherence to documentation standards Required qualifications: High School Diploma / GED Certified Professional Coder (CPC) or RHIT certification Professional certification as a Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) 5+ years of experience in fraud investigations or FWA/SIU roles 2+ years of experience in the health insurance claims industry Virtual Vocations Inc
$25 - $29 per hour
For the past 28 years, Advantage Investigations has been the Nation's only insurance defense investigation firm that invests in the operational... ...cases. Advantage Investigations is seeking a Part-Time SIU/Claims Investigator in NYC, NY /Surrounding Areas . The...SuggestedBi-weekly payHourly payPart timeWork at officeRemote workFlexible hours- National General Insurance is seeking an experienced SIU Field Investigator to join our Special Investigations Unit in New York. This field-based role requires residence in or near Bronx, Manhattan, Westchester, or surrounding areas. You will conduct complex investigations...Suggested
$46.99k - $112.2k
...family and one community at a time. Position Summary The Senior Investigator, Aetna Special Investigations Unit, will conduct high level,... ...related entities Initiate independently proactive data mining using SIU Tools to identify aberrant billing patterns and early scheme...SuggestedHourly payFull timeTemporary workWork at officeLocal area$32 - $38 per hour
...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...Suggested- ...CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit. The role focuses on complex national healthcare fraud investigations across multiple lines of business, including Medicaid-related matters. You will conduct research, perform data mining...Suggested
- ...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...
$56.2k - $101k
...perspective on workplace flexibility. Candidates residing in the state of New York are highly preferred. Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations...Full timePart timeWork at officeRemote workFlexible hours$56.2k - $101k
...Position Purpose Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical records, provider information, and other relevant evidence to identify potential misconduct and support case resolution. Document investigative activities...Full timePart timeH1bWork at officeRemote workFlexible hours- Working remotely, the full-time Desktop Claims Investigator will investigate and evaluate potentially fraudulent claims, conduct complex claim investigations, and prepare detailed reports while maintaining communication with various divisions. Key responsibilities Investigates...Full timeRemote work
$60k - $87.4k
...directly to consumers. Job Description This job is responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation unit (SIU) for potential fraud. This role typically handles a combination of...Work at officeWork from homeVisa sponsorshipWork visa- Delta Group is a private, national investigative firm established in 1983, headquartered in Buford, GA, with nationwide coverage. The Special Investigation Unit handles claims across lines, focusing on workers’ compensation and other insurance investigations. The team emphasizes...
- Centene Corporation in New Jersey is seeking an experienced Fraud, Waste, and Abuse (FWA) Investigator to review referrals, claims data, medical records, and provider information to identify misconduct and support case resolution while ensuring compliance with laws and...
- MetroPlusHealth in New York seeks a Clinical Certified Coder to support fraud detection and investigations in the Special Investigations Unit. The successful candidate will review medical records and claims, conduct audits, and collaborate with the team on suspected fraudulent...
$28 - $32 per hour
...Job Type Part-time Description Command Investigations, LLC is seeking an Insurance Field Investigator with a minimum of three years... ...team. This is a great opportunity for individuals with prior SIU experience who demonstrate integrity, independence, and a drive...Hourly payFull timePart timeWork at officeRemote workFlexible 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 medical records, documenting findings, and ensuring compliance with coding guidelines. The position is remote...Remote jobFull time
- ...ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance... ...dynamic Ethos team is seeking a Special Unit Investigations (SIU) Field Investigator to conduct field investigations, gather and...Casual workLocal areaNight shift
$27 - $33 per hour
...Job Type Part-time Description Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum of... ...possess the following: A minimum of 1-3 years of Claims, SIU, or adjusting experience. Other related experience should be indicated...Hourly payPart timeSecond jobWork at officeRemote workFlexible hoursNight shift- ...Becker & Co Inc, located in Georgia, is seeking skilled Field Investigators for flexible hours on an as-needed basis. Ideal for licensed investigators... ...conducting various investigations, including surveillance and SIU assignments, delivering high-quality results tailored to client...Flexible hours
- J T Becker & Co Inc is seeking skilled Field Investigators for flexible hours on an 'as needed' basis. The role involves various investigations, including surveillance and SIU assignments, with a focus on insurance claims and fraud. The ideal candidate will possess a valid...Flexible hours
- J T Becker & Co Inc is looking for skilled Field Investigators to join our team on an as-needed basis. This role offers flexibility, ideal for... ...investigations. Ideal candidates will conduct surveillance and SIU assignments, completing video recordings and maintaining...Flexible hours
- J T Becker & Co Inc is seeking skilled Field Investigators to join our team in New York. This role is perfect for licensed investigators looking... ...various investigations such as surveillance assignments and SIU investigations. Key responsibilities include adhering to case...Flexible hours
- J T Becker & Co Inc is seeking skilled Field Investigators in Pennsylvania for flexible, as-needed investigative work. Ideal candidates will... ...investigator license, and have experience in surveillance and SIU investigations. Work will be carried out with limited supervision...Flexible hours
- J T Becker & Co Inc is seeking skilled Field Investigators in Idaho to provide expert investigative services on an as-needed basis. This role... ...’s license, investigative tools, and experience in surveillance and SIU claim investigations. #J-18808-Ljbffr J T Becker & Co IncFlexible hours
- J T Becker & Co Inc is looking for skilled Field Investigators to join our team on an 'as needed' basis, perfect for those wishing to work flexible... ...will conduct varied investigations, including surveillance and SIU assignments, within New Jersey. Key responsibilities include...Flexible hours
- J T Becker & Co Inc is seeking skilled Field Investigators to join our team on an as-needed basis. This role is perfect for licensed investigators... ...a variety of investigations, including surveillance and SIU assignments, ensuring high-quality results while maintaining confidentiality...Flexible hours
- J T Becker & Co Inc is looking for skilled Field Investigators for flexible hours, ideal for licensed investigators. Responsibilities include video surveillance and SIU investigations, adhering to case manager's instructions and meeting deadlines. The ideal candidate must...Flexible hours
- J T Becker & Co Inc is hiring Field Investigators in Delaware to provide flexible investigative services on an as-needed basis. Ideal candidates... ...will conduct varied investigations including surveillance and SIU assignments, ensuring high-quality results. Applicants must...Flexible hours
- Conducting comprehensive fraud, waste, and abuse (FWA) investigations, the full-time SIU Investigator will analyze claims data, medical records, and provider information while collaborating with internal and external stakeholders to support case resolution and ensure compliance...Full timeRemote work
- About Us Terrance Private Investigator & Associates is a leading private investigation firm serving clients nationwide. We provide professional... ...Minimum of 2 years of professional claims investigation, SIU, or insurance defense investigative experience Demonstrated experience...Full timeWork at officeLocal areaImmediate start
$75.35k - $98.89k
...Job Description Job Description Hi, we're Oscar. We're hiring a Senior Analyst, Special Investigations Unit Clinical Investigator to join our SIU. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on...Full timeWork at officeRemote workWork from homeFlexible hours3 days per week
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