Hybrid SIU Investigator II: Healthcare Fraud & Recovery
Cambia Health Solutions
Cambia Health Solutions seeks a hybrid SIU Investigator II or III to investigate fraud and abuse, review data, and coordinate audits across multiple sites. You will conduct interviews, compile case documentation, and collaborate with agencies to pursue recoveries and improve compliance. Ideal candidates have a strong background in healthcare investigations, relevant certifications, and the ability to train staff while delivering clear findings. #J-18808-Ljbffr Cambia Health Solutions
$57.8k - $78.2k
Special Investigations Unit (SIU) Investigator II or III - DOE Hybrid role (3 days/week in office) at our... ...investigations into allegations of fraud and abuse.... ...investigative support in pursuing recovery of inappropriate and/... ...to ensure every healthcare dollar is spent...FraudWork at officeLocal areaImmediate startWork from homeRelocationFlexible hours3 days per week$65k - $88.6k
...of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and... ...Bachelor's degree • 2 years of healthcare fraud investigations and auditing... ...Requirements: To ensure Home or Hybrid Home/Office employees’ ability...FraudFull timeTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- Bluevineus in Salt Lake City is looking for a Fraud Servicing team member who will investigate and mitigate potential fraud. The role requires excellent customer... ...of customer support experience and must enjoy a hybrid working model, spending 2 days in the office and 3...FraudWork at office
$65k - $88.6k
...part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and... ...2 years of experience in healthcare fraud investigations Knowledge of... ...expense Humana will provide Home or Hybrid Home/Office associates with telephone...FraudBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$107.9k - $172.64k
...Cross NC is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical... ...and correcting health care fraud, waste, and abuse. This... ...interpretation of complex healthcare claims data to identify emerging... ...Where You'll Work Our Hybrid Flex approach is built on presence...FraudWork at officeLocal areaRemote workFlexible hours2 days per week- ...Humana Inc. is seeking a Fraud and Waste Professional 2 to coordinate investigations of fraudulent and abusive practices across internal and external entities, assemble evidence, and prepare complex investigative and audit reports in support of adjudication. This is a...FraudRemote work
- ...in Utah is seeking a strategic analytics partner for the SIU and Payment Integrity teams. The role delivers... ...intelligence, financial reporting, and audit support, transforming healthcare data into insights for fraud detection and operational improvements. You will design...Fraud
- Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and auditors focused on detecting, preventing, and correcting healthcare fraud, waste, and abuse. This role ensures patient care is accurately documented...FraudRemote job
- ...Health and Human Services is seeking a highly motivated Lead Investigator to manage investigations of unlicensed programs and violations... ...The role requires travel and overnight stays statewide, with hybrid work in Salt Lake City. The position emphasizes regulatory compliance...Night shift
$62.7k
...developing and maintaining an anti-fraud program which includes... ...responsible for conducting investigations of organizational or functional... ...and coordinating the recovery/savings of money related to... ...health insurance industry and/or healthcare fraud investigations Preferred...FraudContract workFor contractorsWork at officeLocal area$89.17k - $142.68k
...analytics partner to the Special Investigations Unit (SIU) and Payment Integrity... ..., dashboard development, healthcare claims expertise, and stakeholder... ...engagement to identify fraud, waste, abuse, payment... ...investigations, overpayment recovery efforts, prepayment and post...Fraud- ...labor agency is seeking an Employment and Housing Discrimination Investigator in Salt Lake City, Utah. This position involves investigating... ..., and excellent communication abilities. The role offers a hybrid work model and comprehensive benefits including health and retirement...
$65.1k - $109.3k
...user experience. In this position… The Fraud Analyst reports to the Fraud Manager and... ...responsible for the real-time monitoring and investigation of suspicious activity across the bank’s... ...call (***) ***-****. This position is hybrid. Candidates who are in commuting...FraudWork experience placementImmediate startFlexible hours- Stride Bank Na is seeking a BSA Investigations Analyst II to research customer and transactional data, document findings, and report to government agencies. The role requires evaluating alerts and conducting enhanced due diligence on high-risk accounts. You will escalate...Fraud
- ABOUT US Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making for...FraudLocal areaNight shiftWeekend work
$140k - $200k
...all of us. This senior role of fraud analytics is responsible for... ...Able to lead fraud/risk investigations for both simple and complex cases... ...financial services, insurance, and healthcare industries. FinTech or start-... ...” roles. Business Analyst II - Remote for those living in...FraudFull timeRemote work- ...Percentage: Up to 25%Job Shift: DayJob Category: BankingThe BSA Investigations Analyst II is responsible for the research and investigation of... ...crime, identity theft, terrorist financing, human trafficking, fraud, or other types of suspicious activity are occurring....FraudShift work
$71.9k - $189k
Clinical Research Associate II & Senior Clinical Research Associate... ...relationships with investigators and site personnel.Key ResponsibilitiesConduct... ...’s degree in Life Sciences, Healthcare, Nursing, or a related field... ...policy for candidate fraud. All information and...FraudFull timePart timeWork at officeImmediate startWorldwide- ...responsible for day-to-day management of the Bank's suspicious activity monitoring and surveillance tool. Incumbent will conduct investigations of unusual account activity in accordance with the Bank's BSA/AML Program and FFIEC guidance. The incumbent will perform the...Fraud
- ...great work experience, or are you an EEO Investigator looking for a new challenge? If so, please... ...and Labor Division (UALD). This is a hybrid position offering in-person and telework... ...have two options for retirement in the Tier II System. Tier 2 Hybrid Retirement System....Full timeWork experience placementWork at officeRemote workWork from home
$25 - $30 per hour
Description Command Investigations, LLC is looking for Surveillance Investigators to become part of a dynamic team. This is a great opportunity for individuals with prior investigative experience who demonstrate integrity, independence, and a drive to succeed in a fast...Hourly pay16 hoursFull timeWork at officeRemote workFlexible hoursShift workNight shiftWeekend work$24.95 - $42.38 per hour
...Medical Examiner Investigator FT / PT Status – Part-Time Salary – $24.95 - $42.38 Hourly Wage... ...Medical Examiner Investigator (Investigator II, non-post) is responsible for providing... ...This position may be eligible to work a hybrid schedule of both in-office and telework days...Hourly payPart timeWork at officeRemote workNight shift- Ford Motor Company seeks a Fraud Analyst to monitor and investigate real-time fraud across Ford Credit's online platforms and payment rails. You will work with leadership to resolve fraud events and identify trends to keep de novo operations secure. You will collaborate...Fraud
- ...seeking a BSA/AML Analyst to join the second line of defense. You will perform customer due diligence, transaction monitoring, and investigations to protect the bank and ensure regulatory compliance. You’ll report to the BSA/AML Officer and collaborate across Risk, Cyber,...
$43.89k - $93.57k
...medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices... ...behavioral, transportation and other healthcare providers. The CPC must have the... ...potential billing errors, abuse, and fraud. Identify opportunities for savings related...FraudHourly payFull timeTemporary workLocal area$100k - $150k
...for a better today and tomorrow. Ascensus is seeking a Senior Fraud Strategy Analyst to join our Fraud Risk Management team. This... ...3-7 years of progressive experience in fraud strategy, fraud investigations, financial crimes, or financial services risk management Experience...Fraud$47.5k - $69.8k
...Description Responsible for investigating and confirming the facts of loss... ...Determines subrogation or fraud potential and how to handle Skills... ...for this role is: Analyst II: $47,500.00 - $69,800.00... ..., HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing...FraudContract workWork at officeWork from homeVisa sponsorshipWork visa- The University of Utah in Salt Lake City seeks a faculty member to lead addiction-related research and promote collaboration across health services and intervention studies. You will work within the Division of Epidemiology and partner with the Salt Lake City Veterans ...
$125k - $135k
...make a positive impact on patients’ lives? Do you have Electronic Healthcare Record (EHR) experience and are looking for a rewarding career... ...process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application...FraudFull timePart timeImmediate startWorldwideNight shift- ...position (classified for 40 standard weekly hours) that is eligible for bonuses; medical, dental, vision, telehealth and mental healthcare; health savings account and flexible spending account; basic and voluntary life insurance; disability coverage; accident, critical...Full timeFlexible hours
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