- AmeriHealth Caritas (Columbia, SC)
- …Accountabilities:** + Ensures compliance with all requirements related to Special Investigation Units and fraud, waste and abuse investigations . + Conducts ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of… more
- Elevance Health (Chicago, IL)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Nurse/CPC - Clinical Fraud Investigator II - SIU...experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or… more
- US Capitol Police (Washington, DC)
- …of the ID; Prepare and disseminate written reports including reports of investigation , various investigative assessments, and investigations bulletins; Perform a ... mitigation, Member protection, and enforcement strategies. Specialty Units include Investigations , Intelligence and Interagency Coordination, and Dignitary Protection. A… more
- Molina Healthcare (Tacoma, WA)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, ... audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to make medical determinations… more
- Molina Healthcare (AZ)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, ... audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to make medical determinations… more
- Mayo Clinic (Rochester, MN)
- …or Mower County or be willing to relocate to apply.** As a Medicolegal Death Investigator , you will be conducting death investigations on an on-call basis for ... generates reports. + Writes complete, accurate and comprehensive statement of investigations . + Provides timely communication of pertinent case information to… more
- Centene Corporation (Austin, TX)
- …ancillary, behavioral health care, laboratory, etc. Provides investigative support to the Special Investigations Unit (SIU) related to coding and billing issues ... with investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing...and 2 years of relevant experience required. 2+ years clinical experience with independent license required; 2 years of… more
- CVS Health (Hartford, CT)
- …and affordable. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). ... In this role, you will manage complex investigations into suspected and known acts of healthcare fraud,...claimants, and customers. + Researches and prepares cases for clinical and legal review. + Documents all appropriate case… more
- University of Utah (Salt Lake City, UT)
- …+ Established track record of research accomplishments with a focus on clinical investigation and/or health services research + Eligibility for licensure ... Position Information **Position/Rank** General Internal Medicine Clinician Investigator **Department** 00232 - General Internal Medicine **City** Salt Lake City, UT… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The AVP Special Investigations Unit (SIU) is responsible for overseeing and managing fraud, waste, and abuse (FWA) detection, ... law enforcement agencies, regulatory bodies, and external partners during investigations . + Prepare comprehensive reports summarizing investigation outcomes,… more