Fraud & Abuse SIU Manager - Hybrid/Remote Lead Investigator
Centene Management Company LLC
- Remote job
Centene is seeking a senior fraud and abuse investigator to develop, implement and manage strategic activities ensuring compliance in billing and claims payment. You will monitor trends, lead investigations and prepare saving reports while collaborating with various stakeholders. You will also develop educational materials, participate in meetings, and guide a team through complex referrals, ensuring adherence to state and federal requirements. #J-18808-Ljbffr Centene Management Company LLC
$70.1k - $126.2k
...flexibility. This is a remote role anywhere... ...members who investigate and remediate... ...and fraud, waste, and abuse related matters. Assists manager on monitoring... ...casework and other SIU activities. Evaluates... ...proactive leads for... ...with remote, hybrid, field or office...Remote workFraudFull timePart timeWork 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
$56.2k - $101k
...Fraud, Waste, and Abuse Investigator Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data... ...plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted...Remote workFraudFull timePart timeH1bWork at officeFlexible hours- VRC Investigations in Phoenix, AZ is seeking experienced SIU investigators for part-time (and full-time hourly) roles. This hybrid position requires travel within the city and state and offers work... ...professionals to deter insurance fraud. You will conduct multi-line...Remote jobFraudHourly payFull timePart timeWork from home
- Elevance Health is seeking a Business Change Director - SIU Fraud and Abuse (AI) to lead AI strategy, adoption, and value realization across the AI... ...across executive teams while driving measurable outcomes. Hybrid work with in-office collaboration is emphasized. #J-1880...FraudWork at office
- Medica in Minnetonka, MN is seeking an SIU Investigator IV to lead advanced fraud, waste, and abuse investigations involving members, providers, and employees. You will manage complex cases, review evidence from multiple sources, and guide actions that support legal or...Fraud
$56.2k - $101k
...candidates must reside in Arkansas. Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and... ...holidays a flexible approach to work with remote, hybrid, field or office work schedules Actual pay...Remote workFraudFull timePart timeWork at officeFlexible hours- Loyalty MGA LLC is seeking a SIU Investigator to identify and investigate potential fraudulent claims. The role supports fraud prevention and requires collaboration with internal teams. A hybrid work schedule is available after probation. The ideal candidate has strong...FraudTrial period
$87.7k - $157.8k
...Position Purpose: Leads the strategic direction... ...optimization of SIU capabilities that support... ..., prevention, and investigation of fraud, waste, and abuse (FWA). Drives the... ..., and priorities. Manages, mentor, and... ...approach to work with remote, hybrid, field or office work...Remote workFraudFull timePart timeWork at officeFlexible hours$48.19k - $72.28k
...position will be to investigate potential cases of fraud across the... ...candidate will lead investigations that... ...to effectively manage fraud alerts, identify... ...fraud and abuse, identify, and analyze... ...office - Hybrid: 2 days in office... ...Time Off and Remote Work Flexible...Remote workFraudFull timeWork at officeWork from homeFlexible hours- ...MGA in Miami, FL is hiring an SIU Investigator to identify and investigate... ...claims. The role offers a hybrid schedule after probation and... ...evidence collection to support fraud prevention. You will analyze... ..., and present findings to management and regulators while collaborating...FraudTrial period
$70k - $80k
...Insurance Group has an opening for a SIU Desk Investigator that is part of the Special Investigation... ..., PA office with transition to a hybrid schedule upon successful completion of... ...designated assignments related to Company anti-fraud initiatives Establish and maintain...FraudPermanent employmentFull timeTemporary workWork at office- The Missouri Department of Mental Health (DMH) Investigations Unit seeks an Abuse/Neglect Investigator to be domiciled in St. Louis, Missouri, within the IU’s East Region. Hybrid/remote work options may be available after onboarding and training. This role requires an...Remote job
- Turo seeks an experienced Claims SIU Investigator in Phoenix to uncover fraud and misrepresentation in claims. You will review files, gather evidence, interview... ...while ensuring regulatory compliance. This role is hybrid and in-office several days a week. #J-18808-Ljbffr...FraudWork at office
- ...is one of the nation’s leading specialized insurers.... ...Position Summary:The SIU Investigator will conduct field as... ...Investigator will function as a remote investigator working... ...of Insurance Fraud Division, NICB, and various... ...required by law and management. Keeps the Special Investigation...Remote workFraudFull timeWork experience placementWork at office
$115.36k - $207.65k
Business Change Director - SIU Fraud and Abuse (AI) Location: This role requires... ...note that per our policy on hybrid/virtual work, candidates not... ..., and scope impacts, and lead efforts to establish best... ...project, process, and change management coaching and consulting support...FraudTemporary workWork experience placementWork at officeLocal area3 days per week1 day per week$25 - $29 per hour
...alternative application process. SIU Investigator Part Time Technical Las Vegas... ..., Net-Sweep Investigations, Remote Controlled Surveillance, and... ...time and money on insurance fraud cases. Advantage... ...assignment. Consults with the Manager on appropriate strategies for...Remote workFraudBi-weekly payHourly payPart timeWork at officeFlexible hours- ...application. Healthcare Fraud Shield will not... ...Coder/Fraud Investigator to join our team.... ...Work with SIU Team (Clinical Reviewers... ...data analysis and lead generation/data mining... ...secure information management CERTIFICATE/LICENSE... ...initiatives ~ Remote work eligible...Remote workFraudFull timeFlexible hours
$25 - $50 per hour
...office politics Strong management support Professional autonomy... ...Paid travel for field investigations when required Job Summary The SIU Investigator conducts field and remote investigations involving... ...compensability analysis, fraud indicators, and investigative...Remote workFraudHourly payPart timeWork at officeHome officeFlexible hoursAfternoon shift$49.7k - $88.8k
...together. The Investigator is responsible... ...prevention of healthcare fraud, waste, and abuse. The... ...Warwick, RI Hybrid role with expectation... ...flexibility to hybrid-remote* as you take on... ...Investigations Unit's (SIU's) case tracking... ...the direction of management You'll be...Remote workFraudMinimum wageFull timeWork experience placementWork at officeLocal area- Centene Corporation is seeking a seasoned Health Care Fraud Investigator to support a remote SIU team across the continental US. You will guide investigations... ..., knowledge of government programs, and the ability to manage complex caseloads. This position offers flexible remote...Remote jobFraudFlexible hours
- 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
- ...happen. Job Summary A Special Investigations Unit (SIU) Desk Investigator within an insurance... ...investigations involving suspicions of insurance fraud related to the application of... ...weekly Investigator report to manager Attends and participates in team meetings...Remote workFraudContract workWork at officeRelocation package
- Centene Corporation seeks an investigator to conduct fraud, waste, and abuse investigations across healthcare data, records, and referrals. You will prepare... ...external agencies is common, and a flexible schedule with potential remote #J-18808-Ljbffr Centene CorporationRemote jobFraudFlexible hours
- ...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
- Kemper Corporation seeks a Special Investigative Unit (SIU) Investigator to conduct field and desk investigations of insurance claims. The role operates as a remote investigator servicing Houston and surrounding areas, with travel as needed, and involves Examinations Under...Remote jobFraud
- ...for the next step in your career? Lead Special Investigator (General) in Hartford, CT WHAT WE OFFER... ...Columbus Blvd in Hartford, CT This hybrid position is eligible to apply for... ...investigations of licensee complaints, frauds, and abuse in concert with division criminal...Remote workFraudFull timeWork at officeAll shiftsMonday to FridayShift workWeekend workDay shiftAfternoon shift
$30 - $35 per hour
VRC Investigations is seeking experienced Part-Time SIU Investigators to join its team in Las Vegas, Nevada. You will investigate potential insurance fraud, conduct interviews, and document findings in detailed reports. The role requires excellent communication, analytical...Remote jobFraudHourly payPart time- 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... ...subject matter expertise for clients. Remote work eligible; 401(k), generous PTO, and professional...Remote jobFraud
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