Claims Case Investigator Jobs in Texas

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483 Texas Claims Case Investigator jobs found on Monster.

Jobs 1 to 20 of 483
Position Description: Job Summary: The SIU (Special Investigative Unit) Investigator will assist the Associate Director of Compliance and Regulatory Affairs in the development, maintenance and execution of the Navitus fraud, abuse and waste program, controls, and associated policies and procedures. The SIU Investigator will conduct prompt, accurate investigations of questionable cases, in a mann...
Allstate Houston, TX
Job Description: Allstate® GoodWork. Good Life. Good Hands.® Votedone of the World’s Leading Top 100 Companies by Forbes magazine Do you have an eye for detail? Do you have strong organizational and time management skills? Are you looking to accelerate your career at a renowned company? Allstate Insurance has an exceptional career opportunity for a Field Property SIU Investigator in Malvern, ...
Position Description: The SIU Medicare Parts C and D Investigator functions as part of the SIU, which is the designated unit responsible for the detection, prevention, investigation, education, correction, and resolution of Medicare Parts C and D FWA. This position is responsible for triaging, investigating and resolving all instances of potential Medicare Parts C and D FWA, which may include, bu...
At Gallagher Bassett (GB) we are constantly seeking skilled professionals who are up for a challenge and take exceptional performance to heart. The professionals we hire help us maintain our reputation as one of the most progressive property/casualty third party claims service organizations in our industry and throughout the world. Gallagher Bassett provides services to Fortune 1000 companies thro...
Allstate® Good Work. Good Life. Good Hands.® Voted one of the World’s Leading Top 100 Companies by Forbes magazine Allstate Insurance Company has a fantastic opportunity for a Senior Casualty Claims Adjuster in the Houston, TX area!   Combine your skills of communication, working with people, investigation and negotiation. Our customers need us the most when they are involved in an accident....
Investigator V - The Field Investigator (FI) conducts administrative investigations and criminal investigations submitted to the District or County Attorney for individual's who have committed fraud in HHS programs. Individual will prepare evidence and testify during Administrative Disqualification Hearings and criminal court proceedings. Investigates and establishes claims on overpayments in the ...
The posting is for 1 positions in Houston Investigator V The Field Investigator (FI) conducts administrative investigations and criminal investigations submitted to the District or County Attorney on individuals who have committed fraud in HHS programs or who have received other overpayments. The incumbent will prepare evidence and testify during Administrative Disqualification Hearings and crim...
Investigator V The Field Investigator (FI) conducts administrative investigations and criminal investigations submitted to the District or County Attorney on individuals who have committed fraud in HHS programs or who have received other overpayments. The incumbent will prepare evidence and testify during Administrative Disqualification Hearings and criminal court proceedings. Investigates and es...
Smoky Mountain Center Houston, TX
Job Description: SPECIAL INVESTIGATOR-CLINICAL Under the direct supervision of the Program Integrity Director, the special Investigator/Clinical participates in post-payment reviews and investigations as needed to ensure the financial and clinical integrity of the Smoky Mountain LME/MCO (Smoky) mental health, developmental disability, and substance abuse provider network. As assigned by the Prog...
JOB SUMMARY: PLEASE NOTE: The agency has decided not to fill vacancies at the Reading, PA location at this time. The Department of Labor (DOL) seeks to attract and retain a high performing and diverse workforce in which employees' differences are respected and valued to better meet the varying needs of the diverse customers we serve. DOL fosters a diverse and inclusive work environment that prom...
Universal American Houston, TX
Job Description: The SIU Medicare Parts C and D Investigator functions as part of the SIU, which is the designated unit responsible for the detection, prevention, investigation, education, correction, and resolution of Medicare Parts C and D FWA. This position is responsible for triaging, investigating and resolving all instances of potential Medicare Parts C and D FWA, which may include, but is ...
Responsibilities - The primary responsibilities of this position include the following activities related to insurance claims investigations: Detailed claim review with ability to ascertain relevant issues such as material misrepresentation, coverage, exclusions, fraud and red flags. Development of investigative plan of action. In-person interviews. Written and recorded statements. Court, public a...
Responsibilities - The primary responsibilities of this position include the following activities related to insurance claims investigations: Detailed claim review with ability to ascertain relevant issues such as material misrepresentation, coverage, exclusions, fraud, and red flags. Conducting surveillance (fixed/mobile) Obtaining videotaped documentation of subjects Conducting background/activ...
Position Description: Are you interested in an opportunity to empower individuals to become self-sufficient with their health and wellbeing, while maintaining an excellent work/life balance? If so, consider our opportunity in helping others in your community improve their health-related quality of life. Universal American has an exciting opportunity for a Field Based RN Case Manager to work in t...
Marten Transport Dallas, TX
USAA is currently seeking talented *SIU Investigator* for our *Dallas, TX* location. *PURPOSE OF JOB* Provide specialized investigative and advisory services, particularly when claim or underwriting fraud is suspected. Increase fraud awareness throughout USAA and its membership. Develop innovative and long-term fraud detection and prevention programs. Support public entities and other industr...
Job Preview: USAA is currently seeking talented SIU Investigator for our Dallas, TX location. PURPOSE OF JOB Provide specialized investigative and advisory services, particularly when claim or underwriting fraud is suspected. Increase fraud awareness throughout USAA and its membership. Develop innovative and long-term fraud detection and prevention programs. Support public entities and other in...
USAA is currently seeking talented SIU Investigator for our Dallas, TX location. PURPOSE OF JOB Provide specialized investigative and advisory services, particularly when claim or underwriting fraud is suspected. Increase fraud awareness throughout USAA and its membership. Develop innovative and long-term fraud detection and prevention programs. Support public entities and other industry grou...
Investigator VII Lead Electronic Benefits Transfer (EBT) Investigator performs highly advanced (senior-level) investigative and managerial work managing, planning, developing, and implementing programs for Office of Inspector General (OIG) General Investigations (GI). Work involves providing consultative and technical services to agency staff, other governmental agencies, community organizations,...
The Robison Group San Antonio, TX
Surveillance Investigator: Individuals selected for the position will be expected to perform stationary and mobile surveillance investigations of workers compensation claims, liability investigations, and other investigative services.? Preference to those with a minimum six months to one year experience conducting surveillance and whom are currently licensed to work as a Private Investigator, ho...
Alliance Data Houston, TX
Job Description: Qualifications & Responsibilities As a Fraud Investigator, you will be responsible for reducing losses on fraud cases by setting up and investigating cases for recovery opportunities. Opportunities are achieved through restitution, chargeback’s, working directly with clients and reviewing activity with cardholders to identify save opportunities. Utilizing your excellent problem ...

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