- 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 ... in our communities and customers we serve. We offer medical , dental and vision coverage, life insurance, retirement plan,...Insurance claims through scene Investigations, claimant and witness Interviews, document… 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 ... City and related entities, and their employees. The Paralegal Claims Investigator 's role involves assistance in pre-litigation...or suits against the City; evaluation and analysis of medical records related to personal injury claims ;… more
- Allied Universal (Tallulah, LA)
- …jobs! Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with ... in our communities and customers we serve. We offer medical , dental and vision coverage, life insurance, retirement plan,...policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for… 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 ... Degree in Criminal Justice or similar + Bilingual candidates Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Dynamic and fast paced work… 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: + ... in Criminal Justice or similar + Bilingual candidates Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Extensive performance bonus program… 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 + ... to include Microsoft Word and Microsoft Outlook email Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Extensive performance bonus program… more
- Commonwealth of Pennsylvania (PA)
- … medical assistance funds, notifying relevant parties of DHS interest, initiate requests of medical claims for review, and follow up to ensure payment of the ... + Credits/Clock Hours 10 WORK BEHAVIOR 2 - INVESTIGATES PERSONAL INJURY CLAIMS AND THEIR ESTATES Investigates medical assistance recipients' personal injury… 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 to identify suspicious billing patterns and trends.… more
- Commonwealth Care Alliance (Boston, MA)
- …reports. **What You'll Be Doing:** **Essential Duties & Responsibilities:** + Conduct prospective medical record review of claims as part of a prepayment review ... Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr. Associate is an integral part of...recommendations. + Review and analyze internal and external referrals, claims and associated medical records to identify… more
- State of Georgia (Fulton County, GA)
- …AND two (2) years of clinical experience AND one (1) year experience working with medical claims . Preference will be given to applicants who hold a Bachelor's of ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only) Hot...experience; additional years of experience in the analysis of medical claims and/or claims data;… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Human Rights Investigator ** **Job Class: Human Rights Investigator ** **Agency: Human Rights Dept** + **Job ID** : 77005 + **Location** : St. ... at MDHR is responsible for thoroughly and impartially analyzing and investigating claims of discrimination from members of the public, by referring individuals to… more
- SGI Global, LLC (Raleigh, NC)
- …complicated and highly technical, regulatory, and/or scientific data and documents, including medical records, medical claims data, prescription data, ... SGI Global is seeking a Civil Investigator (Healthcare Fraud and Opioid Matters) to support...interviews, and prepares associated reports. + Gathers and examines medical records, pharmaceutical records, claims data, prescription… more
- Elevance Health (Columbus, OH)
- …Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical -expense spending. The **Senior Investigator ** is responsible for the ... **Senior Investigator ( Investigator Sr)** _Location: This position...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Independent Health (Buffalo, NY)
- …investigation experience involving economic or insurance-related matters; or an authorized medical professional to evaluate medical -related claims . + ... Experience with medical insurance claims and medical record reviews/audits using standard coding (HCPC, CPT, ICD-9, ICD-10) required. Experience in a managed… 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
- Molina Healthcare (Albuquerque, NM)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and...may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to… more
- Immigration and Customs Enforcement (IN)
- …Office of the Chief of Staff. The incumbent serves as an entry-level investigator in the IHSC Investigations Unit (IIU). This is a non-supervisory position. This ... not eligible for this position. Responsibilities DUTIES AND RESPONSIBILITIES: As an Investigator , the incumbent will perform, but not limited to, the following… more
- US Agency for International Development (Washington, DC)
- …and Millennium Challenge Corporation (MCC). Responsibilities As a GS-13 Criminal Investigator you will: Conduct complex and large-scale criminal, civil, and ... Applicants may make changes to applications to ensure experience is current. MEDICAL REQUIREMENTS: The duties of this position require moderate to arduous physical… more
- State of Minnesota (St. Paul, MN)
- … reviews complaints against public health care providers; evaluates and analyzes claims data, medical records, and financial records; conducts research and ... **Working Title: Lead Investigator (Auditor) - Medicaid Fraud** **Job Class: Legal...the Minnesota Attorney General is currently seeking a Lead Investigator - Auditor in the Medicaid Fraud Division of… more
- LTCG (MN)
- …of its customers. With illumifin, there's a brighter future A SIU/Fraud Investigator is responsible for working with multiple business units on coordination, ... fraud, waste, and abuse from both auto-detection programs and from claims organization, as assigned * Coordinates and performs investigations with oversight… more