Fraud & Abuse SIU Investigator (Hybrid/Remote)
Centene Corporation
- Remote job
Centene Corporation is seeking an Investigator to address allegations of healthcare fraud within Kentucky's Medicaid Program. The role involves planning investigations, performing data analysis, documenting findings, and providing updates to Health Plans. Qualified candidates should possess a Bachelor’s degree in a related field and a minimum of three years of fraud investigation experience, along with residency in Kentucky. The position offers a competitive salary and a flexible work arrangement. #J-18808-Ljbffr Centene Corporation
- Summa Health is seeking an Investigator for Fraud, Waste, and Abuse (FWA) in Cleveland, Ohio. The role involves conducting complex investigations to identify... ...ensures competitive pay and comprehensive benefits. A hybrid work option is available. #J-18808-Ljbffr Summa HealthRemote jobFraud
$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$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$56.2k - $101k
Centene Corporation is looking for a dedicated individual to investigate allegations of healthcare fraud in California. The role involves conducting... ...findings, and analyzing claims for potential fraud or abuse. A Bachelor's Degree in Business, Criminal Justice, or...Remote jobFraudFlexible hours$28.1 - $42.15 per hour
...Full-Time / 40 hours / Days Hybrid or Remote Summary Conducts medium to high complexity investigations under general supervision to... ...investigation of healthcare fraud, waste and abuse (FWA), to facilitate the recovery... ...to the plan. Ensures the SIU processes and procedures...Remote workFraudDaily paidFull timeContract workTemporary workLocal areaFlexible hours- Healthfirst is hiring a Remote Investigator for the Special Investigations Unit. This role involves conducting complex investigations of alleged misconduct, compiling data into reports, and presenting findings to the Marketing Incidents Committee. Essential qualifications...Remote jobFraudWork at office
- 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...Remote jobFraudFull time
$93.77k - $179.24k
...military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military... ...Opportunity We are looking for a dedicated SIU Investigator Senior - Major Case Unit. Within... ...claims by investigating complex fraud investigations with significant financial...Remote workFraudH1bLocal areaRelocation package$56.2k - $101k
Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations... ...off plus holidays Flexible approach to work with remote, hybrid, field or office schedules Actual pay will be...Remote workFraudWork at officeFlexible hours$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$77.12k - $147.39k
...military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military... ...needs. The Opportunity As a dedicated SIU Investigator, you will, within defined guidelines and... ...in compliance with state insurance fraud-related laws and regulations and policies...Remote workFraudH1bLocal area$70.29k - $117.16k
Capital Insurance Group is looking for an SIU Investigator based in Phoenix, AZ. The role involves... ...claims, identifying potential fraud, and providing training to claims staff.... ...communication skills. The position offers a hybrid work environment and a competitive salary...Fraud$58k - $90k
...analytical and experienced investigator with a passion for uncovering... ...Investigations Unit (SIU) is looking for a skilled Investigator... ...responding to healthcare fraud, waste, and abuse (FWA), safeguarding our... ...Coder (CPC) #LI-DS1 #LI-Remote Salary range: $58,000 - $90...Remote workFraudFull timeContract workWork experience placementInternship$21 per hour
ZipRecruiter is looking for a Trust & Safety Associate to investigate fraud and ensure a safe platform. This hybrid role in Phoenix, AZ, requires a high school diploma and 1-2 years in customer service or related experience. Responsibilities include verifying employer accounts...Remote jobFraud- ...Management solution! Job Description Summary: The Fraud, Waste, and Abuse Investigations Manager handles the operational activities related to... .... This position will be the point of contact for client SIU's and Pharmacy Audit teams. Primary...Remote workFraudContract workLocal areaMonday to FridayFlexible hoursNight shiftWeekend work
- ...to help make things happen. Job Summary A Special Investigations Unit (SIU) Desk Investigator within an insurance company plays a crucial... ...moderate investigations involving suspicions of insurance fraud related to the application of insurance, auto/property, and...Remote workFraudContract workWork at officeRelocation package
$18 - $30 per hour
...Surveillance Prep Investigator/Surveillance This is a hybrid position in both pre-surveillance research and surveillance... ...work capability in both remote and field environments. Compensation... ...Experience in insurance claims, fraud investigations, or customer service...Remote workFraudHourly payNight shiftWeekend work- ...Technical Abuse Investigator OpenAI's mission is to ensure that general-purpose artificial intelligence... ...This role will work PST and is open to remote work within the United States, though... ...; automation; encryption; terrorism; fraud; violence; child exploitation; data...Remote workFraud
- Point32Health in Canton, Massachusetts is looking for an Investigator II to join their Special Investigation Unit. The role involves leading investigations related to fraud, waste, and abuse, and requires a Bachelor's degree along with relevant experience in health insurance...Remote jobFraud
$25 - $30 per hour
...the past 28 years, Advantage Investigations has been the Nation’s only insurance... ..., Net-Sweep Investigations, Remote Controlled Surveillance, and... ...time and money on insurance fraud cases. Advantage... ...Investigations is seeking a Part-time SIU/Claims Investigator in...Remote workFraudBi-weekly payHourly payPart timeWork at officeFlexible hours- Centene Management Company LLC is seeking a skilled investigator to handle allegations of healthcare fraud and abuse in New York. In this role, you'll plan, organize, and execute claims investigations, utilizing your expertise in data mining and report creation. The ideal...Remote jobFraudFlexible hours
- Zurich North America is seeking an experienced Claims Fraud Investigator to join its Claims Fraud and Investigation team. This role offers a hybrid work model allowing for remote work from several U.S. states, including Arizona. The investigator will conduct thorough investigations...Remote jobFraud
- 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
- ...your job application. Healthcare Fraud Shield will not contact you... ...talented Coder or Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES Work with SIU Team (Clinical Reviewers, CPCs,... ...career development initiatives Remote work eligible REMOTE WORK...Remote workFraudFull timeFlexible hours
$67k - $79k
...Consulting is seeking a Special Claims Investigator to detect and prevent fraudulent... ...for Great American Insurance Group's SIU. This fully remote position allows for up to 30% business... ...experience in Criminal Investigation or Fraud Detection. The salary ranges from $67,...Remote jobFraud- Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS... ...favorably adjudicated DOD background investigation for this position. Veterans,... ...development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department...Remote workFraudContract workFor subcontractorInterim role
- Howard County Government is seeking Investigators for the Office of Inspector General to conduct complex investigations related to fraud, waste, and misconduct. The position requires... ...while maintaining confidentiality. A hybrid work model may be available after a probationary...FraudWork at office
$90k - $125k
...Internal Fraud Investigator (Hybrid) Chicago, IL We are interested in every qualified candidate who is eligible to work in the United States... ...require in-office work Tuesday through Thursday, with remote flexibility on Mondays and Fridays. This schedule fosters collaboration...Remote workFraudFull timeFor contractorsSummer workWork at officeLocal areaMonday to Friday- Aspire General Insurance Company is looking for a Pre-SIU Adjuster to investigate automobile claims with potential fraud. This full-time role, structured as a career... ...and decision-making skills. The position offers a remote work option and various benefits including...Remote jobFraudFull time
- Employee Benefits Corporation is seeking a Fraud Prevention Analyst to identify and... ...and operations. This role involves investigation, analytics, and risk management, providing... ...position offers flexibility to work hybrid or remotely from several states, including North Carolina...Remote jobFraud
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