SIU Clinical Coder & Fraud Investigator
MetroPlusHealth
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 activities. A minimum of 5 years of relevant experience and AAPC coding certification are required. This role emphasizes strong analytical skills, communication, and integrity in handling sensitive healthcare information. #J-18808-Ljbffr MetroPlusHealth
- 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...Suggested
- ...Humana Inc. is seeking an experienced Healthcare Investigator to join its industry-leading Special Investigations Unit (SIU). The role involves investigating fraudulent... .... Ideal candidates have 2+ years in healthcare fraud investigations, strong data analysis skills (Excel...SuggestedRemote work
$60k - $87.4k
...Description This job is responsible for investigating and analyzing complex, multi-... ...referred to the special investigation unit (SIU) for potential fraud. This role typically handles a... ...searches, scene investigations, and clinic inspections; (2) taking recorded statements...SuggestedWork at officeWork from homeVisa sponsorshipWork visa- ...Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate... ...is seeking a Special Unit Investigations (SIU) Field Investigator to conduct field investigations...SuggestedCasual workLocal areaNight shift
$28 - $32 per hour
...Command Investigations, LLC is seeking an Insurance Field Investigator with a minimum of three years experience to become part of a dynamic... ...team. This is a great opportunity for individuals with prior SIU experience who demonstrate integrity, independence, and a drive...SuggestedHourly payFull timePart timeWork at officeRemote workFlexible hours- National General Insurance is seeking an experienced SIU Field Investigator to join the Special Investigations Unit in New York. This field-based role will cover Bronx, Manhattan, Westchester and surrounding areas, performing surveillance, site inspections, witness interviews...Remote job
- Ethos Risk Services is seeking a Special Unit Investigations (SIU) Field Investigator to conduct field investigations, interview witnesses, and produce detailed reports for claims decisions. You will travel to accident scenes, gather evidence, and upload documents into...
- National General is seeking an experienced SIU Field Investigator to join our Special Investigations Unit in New York. This field-based role requires residing in or near Bronx, Manhattan, Westchester, or surrounding areas and involves investigating complex, potentially...Remote job
- Job Summary The SIU Field Investigator is responsible for conducting thorough investigations throughout the states in which we conduct business... ...experience required. Casualty and PIP claims, as well as medical clinic investigations will be highly preferred. Claims and property...Work experience placementWork at officeRemote work
$23 - $30 per hour
Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum of one year of experience to become part of a dynamic... ...employment. What You’ll Need A minimum of 1-3 years of Claims, SIU, or adjusting experience. Other related experience should be...Hourly payFull timeSecond jobWork at officeRemote workFlexible hoursNight shift$32 - $40 per hour
...Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance... ...opportunities for claim investigators, SIU investigators, and surveillance investigators... ...knowledge of insurance policies and fraud components to determine if claims warrant...$62.5k - $72k
...companies in the world. The Opportunity We are looking for an SIU Investigator. In this role, you will play a critical role in enforcing the... ...for complete investigation of claims suspected of fraud. Acts as a Liaison for the Claims Staff in fraud training, awareness...- Lemieux & Associates LLC is seeking a part-time investigator to cover the five boroughs of NYC and nearby areas. Ideal candidates have NYSIF surveillance and SIU/claims investigation experience and reside in Queens or surrounding neighborhoods. You must be timely with follow...Part time
$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. Your... ...services firm specializing in cost containment and anti-fraud related services. We are dedicated to maintaining the highest...Full time- Origin is seeking an experienced SIU Investigator to join our growing team in Las Vegas, Nevada. This role is ideal for investigators with experience handling insurance fraud investigations, obtaining statements, and identifying indicators of fraudulent activity. We are...Flexible hours
$70.1k - $126.2k
...Position Purpose: Provides guidance to team members who investigate and remediate compliance and fraud, waste, and abuse related matters. Assists manager on... ...training and mentoring to team on casework and other SIU activities. Evaluates and assesses allegations to...Full timePart timeWork at officeRemote workFlexible hours$95k - $120k
About the role AIG is seeking a Fraud Investigations Manager who is fluent in English and Spanish (reading, writing, and speaking) to join the Global Investigative Group (“GIG”) team in our New York Office. GIG is a specialized unit within AIG’s Global Legal, Compliance...Full time$85k - $105k
...Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level CGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete...Full timeWork experience placementWork at officeLocal area- ...Customers Bancorp Inc in Malvern, PA, is looking for a Fraud Analyst to join their Fraud Prevention and Investigations team. The role requires expertise in fraud detection and the ability to analyze data to enhance organizational performance. The ideal candidate will have...
- ...claims processes in Idaho. The role involves conducting audits and investigations into customer claims, analyzing data, and communicating... ...Bachelor's Degree and 0-2 years of experience, with healthcare fraud experience preferred. This position offers a chance to contribute...
$91k - $119k
...Salary Range: $91,000.00 - $119,000.00 Role Overview The role involves performing core enforcement reviews, conducting deep-dive fraud investigations, and analyzing fraud trends using data tools. Key responsibilities include providing feedback to improve machine learning...Full timeWork at officeLocal areaVisa sponsorship- ...step of the way. Join us to invest in yourself, your career, and the financial world.The roleWe are searching for a passionate Staff Fraud Risk Analyst who is highly self-motivated, analytical, with a decent understanding of debit card fraud transactions and account...Work experience placementRemote work
- ...high-impact opportunity to join a fast-paced eCommerce risk and fraud operations team. This position supports eCommerce operations by... ...processes. Your language skills will be heavily utilized to investigate cases, communicate with international sellers, and identify region...Contract workFreelanceRemote work
$57.68k - $78.28k
...A government services company is seeking a Financial Investigator responsible for conducting investigations related to federal law violations. Ideal candidates have four years of investigative experience, strong analytical skills, and U.S. citizenship. This full-time...Full time- A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing claims data, and preparing reports. A bachelor's degree and 1+ years in medical claim analysis are essential. Preferred candidates...Remote work
- Oscar Health Insurance is seeking a Senior Analyst, SIU Clinical Investigator to detect and audit aberrant billing patterns in claims and clinical documentation. You will review medical records to ensure alignment with guidelines and regulations, and identify schemes such...Remote jobWork at office
- ...Forensic Accountant Investigator The New York County District Attorney's Office has an immediate opening for a Forensic Accountant Investigator in its Forensic Accounting and Financial Investigation Bureau. In this position the Forensic Accountant Investigator is responsible...Work at officeImmediate startMonday to FridayShift work
$108.6k - $122.46k
...Job Description Division/Unit: Forensic Accounting and Financial Investigation Bureau Civil Service Title: Principal Accountant Investigator Position Title: Forensic Accountant Investigator Salary Range: $108,601- $122,456 Job Description: The New York...Work at officeImmediate startMonday to FridayShift work$115k - $140k
...Fraud Analyst SpaceXAI's mission is to create AI systems that can accurately understand the universe and aid humanity in its pursuit... ...BSA/AML team. In this role, you will support the detection, investigation, and mitigation of financial crime risks, with a strong...Permanent employmentTemporary work- ...building the future, today. About the Role As our Senior Fraud Analyst for Consumer Lending , you will be the gatekeeper... ...team to build, optimize, and scale automated block and manual investigation policies. Advanced Risk Tooling: Liaison with the central...Remote work
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