- MultiPlan (Atlanta, GA)
- …and coordination of benefit techniques to analyze and audit hospital and physician claims to identify errant claim payments. JOB ROLES AND RESPONSIBILITIES: 1. ... to shine! JOB SUMMARY: This role reviews medical paid claims against provider contracts and policies to ensure medical...mining and coordination of benefits techniques to client paid claims data.3. Evaluate medical claims for coding… more
- MultiPlan (Atlanta, GA)
- …and coordination of benefit techniques to analyze and audit hospital and physician claims to identify errant claim payments. The incumbent will assist department ... bright people come to shine! JOB SUMMARY: This role reviews medical paid claims against provider contracts and policies to ensure medical payments have been… more
- Cambia Health Solutions, Inc (Renton, WA)
- …As the face of Cambia, our CSPs play multiple roles - listener, problem-solver, investigator and advocate - all in service of making our members' health journeys ... answer incoming calls on recorded lines, providing guidance and resources on benefits, claims and eligibility. You'll advocate for our members, track down answers to… more
- Allied Universal (Beckley, WV)
- …for most full-time compliance and investigation jobs! Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss ... for Insurance claims through scene Investigations, claimant and witness Interviews, document...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This will include researching and… more
- Allied Universal (Pittsburgh, PA)
- …jobs! Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with ... policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Travelers Insurance Company (Melville, NY)
- …position handles First Party Medical investigations that lead to resolution of claims . Provides quality claim handling throughout the investigation in ... Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is… more
- City of Norfolk, Virginia (Norfolk, VA)
- Paralegal Claims Investigator Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/4519534) Apply Paralegal Claims Investigator Salary ... brought against the City and related entities, and their employees. The Paralegal Claims Investigator 's role involves assistance in pre-litigation claims … more
- Command Investigations (Orlando, FL)
- …for hire. Visit our website and find out why at www.GoCommand.com. The Claims /Field Investigator should demonstrate proficiency in the following areas: + Writing ... accurate and detailed reports + Strong initiative, integrity, and work ethic + Securing written/recorded statements + Accident scene investigations + Possession of a valid driver's license + Ability to prioritize and organize multiple tasks + Computer literacy… more
- Command Investigations (Raleigh, NC)
- …for hire. Visit our website and find out why at www.GoCommand.com. The Claims /Field Investigator should demonstrate proficiency in the following areas: + ... Multi-Lines Experience with an emphasis on Personal Lines + Writing accurate and detailed reports + Strong initiative, integrity, and work ethic + Securing written/recorded statements + Accident scene investigations + Possession of a valid driver's license +… more
- Command Investigations (Buffalo, NY)
- …is a W-2 role; subcontractors will not be considered. The SIU/Insurance Investigator should demonstrate proficiency in the following areas: + P&C investigations + ... Writing accurate and detailed reports + Strong initiative, integrity, and work ethic + Securing written/recorded statements + Ability to prioritize and organize multiple tasks + Computer literacy to include Microsoft Word and Microsoft Outlook email Full-Time… more
- National General Insurance Company (TX)
- National General is seeking an SIU Field Investigator for the San Antonio, or Austin, TX area. The ideal candidate will have previous experience as an SIU ... Investigator within an Insurance carrier. JOB SUMMARYThis job is...responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation… more
- CDPHP (Albany, NY)
- …and invites you to be a part of that experience. The SIU Special Investigator will be responsible for investigating complex insurance cases to detect internal and ... external fraud and abuse. The Special Investigator will research and document cases utilizing resources available...investigation. They will assist in performing audits of providers' claim submissions to assure that services rendered and billed… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and ... Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr. Associate is an integral part of...to identify trends related to potentially inappropriate submission of claims by providers and collaborates with other team members… more
- Elevance Health (Norfolk, VA)
- ** Investigator Sr** **Schedule:** 1-2 days per week in the office (Hybrid 1) **Location:** This position will work a hybrid model (remote and office). The ideal ... 50 miles of one of our Elevance Health PulsePoint locations. The ** Investigator Sr.** position is responsible for the independent identification, investigation and… more
- EFI Global (Edina, MN)
- …requirements for consideration.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, ... large fire loss, and multiple claims .** **Ensures that assigned cases are investigated and reported back to the requesting party in adherence to best practices.… more
- Elevance Health (St. Louis, MO)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator II** **Location** : This position will work a hybrid model...of proprietary data and claim systems for review of facility, professional and… more
- Elevance Health (West Des Moines, IA)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator II** **Schedule** : 1-2 days per week in the office...of proprietary data and claim systems for review of facility, professional and… more
- Molina Healthcare (Albuquerque, NM)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
- Travelers Insurance Company (Melville, NY)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... the structuring and conduction of major case investigations involving multiple claims and/or organized fraud ring activity with regional and national impact.… more
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