Remote SIU Investigator - Healthcare Fraud & Audits
Centene Corporation
Centene Corp. is seeking a full-time SIU Investigator to work remotely in California. This role involves investigating healthcare fraud allegations, performing data mining, and analyzing claims to identify potential abuse. Applicants should possess a Bachelor’s degree and at least one year of relevant experience. The position offers competitive pay, health insurance, and a host of benefits. #J-18808-Ljbffr
$56.2k - $101k
Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing... ...claims investigations or audits that identify, evaluate and measure... ...holidays Flexible approach to work with remote, hybrid, field or office...Remote workFraudWork at officeFlexible hours$56.2k - $101k
Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing... ...claims investigations or audits that identify, evaluate, and measure... ...holidays Flexible approach to work with remote, hybrid, field, or office...Remote workFraudWork at officeFlexible hours- ...solicit your job application. Healthcare Fraud Shield will not contact you prior... ...Coder or Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES Work with SIU Team (Clinical Reviewers, CPCs... ...development initiatives Remote work eligible REMOTE WORK REQUIREMENTS...Remote workFraudFull timeFlexible 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... ...compliance with coding guidelines. The position is remote work eligible, requiring a CPC...Remote jobFraudFull time
$56.2k - $101k
Centene Corporation is seeking a qualified candidate for a remote role focused on investigating healthcare fraud. You will conduct thorough investigations into potential fraud, waste, and abuse, develop analytical reports, and work collaboratively with Health Plans. To...Remote jobFraud- ...Gainwell Technologies is seeking a Fraud and Abuse Review Nurse- Remote to provide expertise in healthcare auditing. This role involves conducting objective audits of service documentation, collaborating with internal teams, and identifying potential fraud while ensuring...Remote workFraud
- ...Description Healthcare Fraud Investigator I - Medicare Remote CA, AZ, OR, WA, UT, MT, ID, NV states @Orchard LLC is retained by a not-for-profit corporation... ...claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination...Remote workFraud
- ...Conduct complex, in-depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain relationships with law enforcement (HHS... ...Provide guidance to the Fraud Investigators on SIU investigations and issues. Assist with anti-fraud...Remote workFraudWork experience placement
$25 - $30 per hour
...A leading investigations firm in Midland, Texas is seeking experienced Part-Time SIU Investigators to join their team. Responsibilities include investigating multi-line insurance claims for fraud, conducting interviews, and documenting findings. Candidates should have...Remote workFraudHourly payPart time- ...A leading investigative firm in Columbia, SC, is seeking experienced Part-Time SIU Investigators to join their team. This hybrid position involves conducting thorough investigations into insurance fraud, performing interviews, and documenting findings. Candidates should...Remote workFraudHourly payPart time
$51k - $80.07k
Healthfirst is looking for an Investigator within the Special Investigations Unit (SIU) to conduct complex investigations of alleged misconduct and fraud in a fully remote position. The ideal candidate must possess an Associate's degree in criminal justice or equivalent...Remote jobFraud- ...expertise, medical coding proficiency, and auditing skills to identify, monitor, and... ...utilization patterns and potential fraud by healthcare providers. You will conduct prepayment... ...How You Will Make an Impact Investigations and Audits : Conduct in-depth medical...Remote workFraudFull timeWork at office
- ...Special Investigations Unit (Siu) Desk Investigator At AssuranceAmerica, we are more than a unique blend of insurance assets. We believe in... ...moderate investigations involving suspicions of insurance fraud related to the application of insurance, auto/property, and...Remote workFraudContract workWork at officeRelocation package
$30 - $35 per hour
A leading investigative firm based in Nashville seeks experienced part-time SIU Investigators to join their team. The role involves investigating potential fraud in insurance claims, conducting interviews, and preparing investigative reports. Candidates should have 5-10...Remote jobFraudHourly payPart timeWork at office$77.12k - $147.39k
...military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military... .... The Opportunity As a dedicated SIU Investigator, within established guidelines and... ...compliance with all relevant state insurance fraud laws, regulations, policies, and...Remote workFraudH1bWork at officeLocal area- Veracity Research Company is seeking experienced SIU Field Investigators to join their Special Investigations Unit in Atlanta, Georgia. This hybrid role involves investigating insurance fraud across multiple lines of business, requiring travel within the region. The ideal...Remote jobFraud
$83k - $132.8k
...Summary: The Special Investigations Unit (SIU) Investigator Lead is the face... ...FWA and support ongoing fraud investigations. Utilizes a... ...Federal and State regulatory audits, as needed Perform any other... ...) years of experience in Healthcare Fraud, Healthcare data...Remote workFraudHourly payWork experience placementLive inWork at office- The SIU Investigator will conduct field as well as desk investigations of insurance claims referred... ...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 workFraudWork experience placementWork at office
$21.82 - $42.55 per hour
Molina Healthcare in New York is seeking an investigator to provide support for special investigation unit (SIU) activities. The role involves investigating health care fraud and abuse, requiring strong analytical, interpersonal, and investigative skills. Candidates should...FraudHourly pay$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...Remote workFraudHourly payPart timeWork at officeHome officeAfternoon shift- Medica seeks an SIU Investigator IV to lead advanced investigations into suspected fraud, waste, and abuse. This role is pivotal in managing complex cases, conducting specialized audits, and ensuring compliance with legal standards. The ideal candidate will have over 7...FraudWork at office
$21.82 - $42.55 per hour
Molina Healthcare is looking for a skilled individual to provide investigative support for the special investigation unit (SIU) focused on medical provider coding fraud, waste, and abuse. The suitable candidate will need to independently evaluate medical claims and maintain...FraudHourly pay$70k - $90k
...A leading healthcare analytics firm is seeking a Senior Investigator to investigate incidents of healthcare fraud, waste, and abuse through data analysis. This remote position requires a Bachelor's degree, 5-8 years of experience in healthcare FWA investigations, and...Remote workFraud- ...Behavioral Health within its Special Investigations Unit (SIU). This remote position requires a Board Certified Psychiatrist with over 5 years of healthcare experience. Responsibilities include... ...psychiatric records for healthcare fraud, collaborating in investigations, and...Remote workFraud
- ...Hispanic Alliance for Career Enhancement is seeking a Senior Healthcare Fraud Investigator for their Special Investigations Unit. This role involves... ..., and cooperation with law enforcement. The position is remote and full-time, requiring 3-5 years of investigative experience...Remote workFraudFull time
- ...The State of Minnesota is seeking an Investigator in St. Paul to work within the Children Youth & Families Department. The successful candidate will conduct investigations and compliance monitoring regarding childcare providers. This full-time position requires a bachelor...Remote workFraudFull time
$70k - $90k
...Senior Investigator - Pre-Pay (Healthcare FWA) Job Location: US-Remote Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not...Remote workFraudWork experience placementWork at officeWork from home- A healthcare organization is seeking a PI Investigator responsible for investigating fraud, waste, and abuse. This role requires 2 years of relevant experience and can be performed remotely in several U.S. states. The ideal candidate will have a background in healthcare...Remote workFraud
- Nashville Public Radio seeks a Program Integrity Investigator to identify and analyze fraud cases under Department of Defense guidelines. Applicants require... ...and a High School diploma. This role emphasizes remote work across various states, ensuring compliance with both...Remote jobFraud
- ...eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for... ...Summary: The Fraud, Waste, and Abuse Investigations Manager handles the operational... ...the point of contact for client SIU's and Pharmacy Audit teams. Primary Responsibilities...Remote workFraudContract workLocal areaMonday to FridayFlexible hoursNight shiftWeekend work
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