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
- National General Insurance is seeking an experienced SIU Field Investigator to join our Special Investigations Unit in New York. This field-based... .... You will conduct complex investigations into potential fraud, gather statements, perform site inspections, and use analytic...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...Suggested
$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...SuggestedHourly payFull timePart timeWork at officeRemote workFlexible hours$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...Casual workLocal areaNight shift
$26 - $33 per hour
...Type Full-time, Part-time Description Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum... ...possess the following: A minimum of 1-3 years of Claims, SIU, or adjusting experience. Other related experience should be indicated...Hourly payFull timePart timeSecond jobWork at officeRemote workFlexible hoursNight shift$25 - $29 per hour
For the past 28 years, Advantage Investigations has been the Nation's only insurance defense investigation... ...save our clients time and money on insurance fraud cases. Advantage Investigations is seeking a Part-Time SIU/Claims Investigator in NYC, NY /Surrounding...Bi-weekly payHourly payPart timeWork at officeRemote workFlexible hours$46.99k - $112.2k
...Position Summary The Senior Investigator, Aetna Special Investigations... ...suspected acts of healthcare fraud and abuse. This position will... ...proactive data mining using SIU Tools to identify aberrant billing... ...and prepare cases for both clinical and legal review Collaborate...Hourly payFull timeTemporary workWork at officeLocal area- ...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... ...various investigations, including surveillance and SIU assignments, with a focus on insurance claims and fraud. The ideal candidate will possess a valid driver’...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 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
- ...Becker & Co Inc is seeking skilled Field Investigators to join our team in New York. This role is... ..., including workers' compensation and fraud. The ideal candidate will conduct various... ...investigations such as surveillance assignments and SIU investigations. Key responsibilities...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
- Humana is seeking an experienced Healthcare Investigator to join its Special Investigations Unit (SIU). You will conduct investigations of fraud, waste, and abuse in Medicare, Medicaid, and commercial programs, collaborating with members, providers, and law enforcement...Remote job
- 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... ...used in claim decisions, litigation, and fraud referrals. Assignments arrive on carrier... ...of professional claims investigation, SIU, or insurance defense investigative experience...Full timeWork at officeLocal areaImmediate start
$32 - $38 per hour
...Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance... ...opportunities for claim investigators, SIU investigators, and surveillance investigators... ...Insurance policies and the components of fraud to determine If claims warrant reporting...Work at officeLocal area- 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
$85k - $105k
...,000.00/yr - $105,000.00/yr Employment Type: Full-Time, Mid-Level Department: Litigation Support 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...Full timeWork experience placementWork at officeLocal area- ...Highmark Health is seeking an experienced professional to develop and maintain the organization’s anti-fraud program, conduct investigations into fraud, waste, and abuse, and coordinate with law enforcement when needed. The role includes field investigations, interviews...
- ...J T Becker & Co Inc is looking for skilled Field Investigators to join their team on an as-needed basis. This role is ideal for licensed investigators seeking flexible hours while providing high-quality investigative services. Investigators will perform surveillance and...Flexible hours
$100k - $135k
...and accurately share knowledge with their teammates.ABOUT THE ROLE:We are seeking a Fraud Analyst to join our BSA/AML team. In this role, you will support the detection, investigation, and mitigation of financial crime risks, with a strong emphasis on fraud-related activity...Permanent employmentFull timeTemporary workWork at officeRemote workWeekend work- ...way. Join us to invest in yourself, your career, and the financial world. The role We 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
$90k - $142k
...Supervisor – Litigation will oversee forensic accounting and litigation support engagements, providing expertise in financial fraud investigations, damage calculations, and dispute resolution. The role involves working closely with attorneys, clients, and internal teams...Full time
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