Senior Investigator, Healthcare Fraud & SIU - National
CVS Health
CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit to lead complex healthcare fraud investigations with national scope. You will conduct data-driven analyses, coordinate with medical directors, and prepare cases for clinical and legal review, while mentoring junior staff. The role requires 2–5 years in healthcare fraud, strong coding knowledge, and advanced Excel/Power BI skills. Travel up to 10% is expected; residence in Oklahoma is preferred. #J-18808-Ljbffr CVS Health
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Senior Investigator, Healthcare Fraud & SIU - National in Brooklyn, NY vacancy
- CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit to lead high-level healthcare fraud and abuse investigations. You will handle national, complex cases, perform data mining, and collaborate with medical directors on clinical issues....SeniorFraud
$46.99k - $112.2k
...time. Position Summary The Senior Investigator, Aetna Special Investigations... ...known or suspected acts of healthcare fraud and abuse. This position... ...matters involving cases that are national in scope, as well as,... ...proactive data mining using SIU Tools to identify aberrant...SeniorFraudHourly payFull timeTemporary workWork at officeLocal areaCVS Health
Brooklyn, NY3 days ago- ## SIU InvestigatorApply: Miami, Florida: Full time: Posted 30+... ...Details***Kemper is one of the nation’s leading specialized insurers... ...***Position Summary:**The SIU Investigator will conduct field as well as... ..., the Department of Insurance Fraud Division, NICB, and various law...FraudFull timeWork experience placementWork at officeRemote work
Kemper
Brooklyn, NY4 days ago $56.2k - $101k
## SIU InvestigatorApply: Remote-NY: Remote-MA: Remote... ...Position Purpose:** Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals,... ...may present risks to healthcare programs and recommend appropriate... ..., gender identity, national origin, disability, veteran...FraudFull timePart timeH1bWork at officeRemote workFlexible hours- ...Centene Corp. seeks an SIU Investigator to conduct fraud, waste and abuse investigations across referrals, claims data and medical records. You will document findings, prepare reports, and collaborate with internal and external partners to support case resolution and regulatory...FraudRemote workVisa sponsorship
Centene Corporation
Brooklyn, NY4 days ago $25 - $40 per hour
...Range: $25.00 To $40.00 Hourly Origin is seeking an experienced SIU Investigator to join our growing team in Los Angeles, CA . This role is ideal for investigators with experience handling insurance fraud investigations, obtaining statements, and identifying indicators...FraudHourly payFlexible hours- Origin Investigations is seeking an experienced SIU Investigator in Los Angeles, CA. The role involves handling insurance fraud investigations, gathering statements, and compiling comprehensive case files. The ideal candidate will possess strong analytical skills, excellent...Fraud
$27 - $32 per hour
...Allied Universal® Compliance and Investigation Services. Allied Universal®... ...for claim investigators, SIU investigators, and surveillance... ...policies and the components of fraud to determine If claims... ...orientation, gender identity, national origin, genetic information,...FraudWork at officeLocal area- JOB SUMMARY Under the guidance of the Fraud Operations Manager, the Senior Fraud Analyst serves in a critical role to prevent, detect, and investigate fraudulent activities. This role is... ...sexual orientation, gender identity, national origin, veteran, or disability status...SeniorFraudRemote job
- ...Professional Charleston, WV, US The Nurse Investigator works as part of the Special Investigations Unit (SIU) team, detecting and investigating suspected fraud, waste, and abuse (FWA). This... ..., detect, investigate, and resolve healthcare fraud, waste, and abuse. Required:...FraudFull timeContract workWork at office
$75k - $85k
...USA Description JOIN A LEADING HEALTHCARE COMPANY Do you dream of a... ...Health continues to be one of the Nation's fastest growing healthcare... ...Health is searching for a Senior Accountant to join our team in... ...to safeguard assets, prevent fraud, and ensure the accuracy and...SeniorFraudCurant Health
Brooklyn, NY4 days ago- Optum is seeking a Coding Consultant to investigate and resolve healthcare fraud and abuse, using CPT coding knowledge to document findings and guide investigations. The role offers telecommuting from anywhere in the United States and targets 8:00am-5:00pm hours with occasional...FraudRemote job
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and provider abuse using CPT coding guidance. You will mentor investigators, review claims against medical records, and coordinate with internal and external stakeholders to ensure...FraudRemote job
$145k - $195k
...for high-impact contributions to Mudflap’s explosive growth. Senior Fraud Analyst Location Palo Alto, CA Employment Type Full time... ...a highly visible role for someone who wants to move beyond investigating individual cases and build the systems, strategies, and analytical...SeniorFraudFull timeWork at officeRemote workMudflapinc
Brooklyn, NY4 days ago- Centene Corporation is seeking an investigator to conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, and medical records to identify misconduct and support case resolution. Responsibilities include documenting investigations, preparing...FraudRemote job
$140.5k - $391.2k
**Senior Director, Customer Delivery Unit (Oncology Portfolio Lead... ..., commercial insights and healthcare intelligence to the life sciences... ..., gender identity, national origin, disability, status as... ...tolerance policy for candidate fraud. All information and credentials...SeniorFraudFull timePart timeImmediate startWorldwide- ...our operating brands, HVACi, StrikeCheck, National Fire Experts, Donan Engineering, BSC... ...Testing Laboratories, The Robison Group, VRC Investigations, TechLoss, Mecanica Scientific Services,... ...Investigator - Special Investigations (SIU) to join our growing team in Houston, TX...Part timeFlexible hoursWeekend workAfternoon shift
- ...professional to support attorneys with financial, healthcare, and forensic accounting analyses for civil fraud cases. The role includes reviewing records,... ...and preparing detailed reports and timelines for investigations and trials. Responsibilities also cover analyzing...SeniorFraudWork at office
- GEICO is seeking a Senior Field Security Investigator to join its SIU team. You will conduct investigations of suspected fraud, interview and take statements, perform inquiries, and locate information and witnesses. You will coordinate with outside agencies and train/ support...SeniorFraud
$129.8k - $361.8k
...Communicate all account activity to Senior Sales Leader and/or... ...services, commercial insights and healthcare intelligence to the life... ...orientation, gender identity, national origin, disability, status as... ...tolerance policy for candidate fraud. All information and credentials...SeniorFraudFull timePart timeWork at officeImmediate startWorldwideIQVIA
Brooklyn, NY1 day ago$80.89k - $94.75k
...Description Summary**he Infectious Diseases Division seeks a Senior Research Investigator to join Dr. Katharine Bar’s translational HIV research lab... ...to race, color, sex, sexual orientation, religion, creed, national origin (including shared ancestry or ethnic...SeniorTraineeshipLocal areaFlexible hoursShift workUpenn
Brooklyn, NY2 days ago- ## Fraud InvestigatorApply: Remote: Ohio (Akron Region): Michigan (Southeast Michigan Region):... ...office on occasion.****Summary:**The Fraud Investigator role within the Fraud Investigations Departments at Huntington National Bank is responsible for investigating various...FraudFull timeH1bWork at officeLocal areaRemote workWork from homeFlexible hours
Huntington
Brooklyn, NY2 days ago - ...Becker & Co Inc is seeking skilled Field Investigators located in Kentucky to serve on an as-needed... ...including workers' compensation and fraud. The ideal candidates should possess strong... ...be able to conduct surveillance, complete SIU investigations, and communicate...FraudFlexible hours
- Peraton is seeking an Experienced Background Investigator to support a national BI program, conducting interviews, records checks, and reporting for federal agencies in a full-time role. The position emphasizes confidentiality, ethics, and the ability to work independently...SeniorRemote jobFull time
$63 per hour
...Boeing Company is seeking an experienced Senior Corporate Investigator to join our team in Everett, WA. This... ...on investigating workplace and fraud related cases, including EEO related... ...the basis of race, religion, color, national origin, sex, sexual orientation, age,...FraudHourly payFull timeContract workWork at office$107.7k - $199.3k
...time. As a diversified, national organization, you’ll... ...high-impact internal investigations across the organization... ...ability to influence senior leadership decisions while... .../Criminology, Law, Healthcare Administration/Health... ...Certifications Certified Fraud Investigator preferred...FraudFull timePart timeWork at officeRemote workFlexible hours- ...position is primarily responsible for handling investigations by assisting members who have... ...implement methods of detecting financial fraud through the identification of suspicious... ...BASIS OF AGE, COLOR, DISABILITY, GENDER, NATIONAL ORIGIN, RACE, RELIGION, SEXUAL ORIENTATION...FraudFor contractorsWork experience placementFor subcontractorWork at officeLocal areaRemote workWork from homeFlexible hours
- ...’s what you will do:**As an Enforcement Investigator, you will investigate allegations of violation... ...of the Oregon Insurance Code, financial fraud, dishonest practices, employee theft,... ...position.* Eligible veterans and Oregon National Guard servicemembers (current and former...FraudFull timePart timeFor contractorsWork at officeRemote work
$74k - $87k
...are the rewards. The Financial Crimes Investigations team protects Robinhood and its customers... ...those with ACAMS certification or Certified Fraud Examiner (CFE) designation. What we... ...without regard to race, color, religion, national origin, age, sex, sexual orientation,...FraudWork at officeFlexible hoursShift work3 days per week- ...Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront of, we provide accurate... ...on the basis of religious creed, sex, national origin, race, veteran status, disability,...FraudFull timeLocal areaNight shiftWeekend work
Ethos Risk Services
Astoria, NYa month ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Investigator, Healthcare Fraud & SIU - National. Be the first to apply!
Related searches
- employee relations investigator Brooklyn, NY
- case investigator Brooklyn, NY
- federal investigator Brooklyn, NY
- investigator Brooklyn, NY
- investigator work from home Brooklyn, NY
- defense investigator Brooklyn, NY
- insurance investigator Brooklyn, NY
- corporate security investigator Brooklyn, NY
- surveillance investigator Brooklyn, NY
- special investigator Brooklyn, NY