Special Investigator Jobs

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GENERAL SUMMARY: The SIU Investigator, in accordance with established policies and procedures, is responsible for processing and performing day to day functions and operations of the SIU department. This includes, but not limited to, the investigation of cases involving complaints where a potential non-compliant incident and/or allegation or a violation of policies and guidelines has been committ...

Description: Do you have a background in investigations of healthcare FWA? Have strong leadership skills? Do you have a desire to work within a collaborative team culture, leveraging diverse strengths for the benefit of the team? Bring us your experience, your head for compliance and investigations, your strength with relationships and your eye for opportunity. In return we offer an unmatched pla...

*0732 Special Investigator SUMMARY: Investigates claims that involve suspicions of fraud or other suspected wrongdoing both internally and externally. ESSENTIAL DUTIES AND RESPONSIBILITES: Include the following. Other duties may be assigned. Identifies fraudulent or criminal activity and those responsible for such activities including arson, automobile accident schemes, personal injury schemes,...

Description: Do you have a background in investigations of healthcare FWA? Have strong leadership skills? Do you have a desire to work within a collaborative team culture, leveraging diverse strengths for the benefit of the team? Bring us your experience, your head for compliance and investigations, your strength with relationships and your eye for opportunity. In return we offer an unmatched pla...

Description: Do you have a background in investigations of healthcare FWA? Have strong leadership skills? Do you have a desire to work within a collaborative team culture, leveraging diverse strengths for the benefit of the team? Bring us your experience, your head for compliance and investigations, your strength with relationships and your eye for opportunity. In return we offer an unmatched pla...

Description: Do you have a background in investigations of healthcare FWA? Have strong leadership skills? Do you have a desire to work within a collaborative team culture, leveraging diverse strengths for the benefit of the team? Bring us your experience, your head for compliance and investigations, your strength with relationships and your eye for opportunity. In return we offer an unmatched pla...

Description: Do you have a background in investigations of healthcare FWA? Have strong leadership skills? Do you have a desire to work within a collaborative team culture, leveraging diverse strengths for the benefit of the team? Bring us your experience, your head for compliance and investigations, your strength with relationships and your eye for opportunity. In return we offer an unmatched pla...

AmWINS Specialty Auto is seeking a career-oriented candidate to join a claims team within our rapidly growing company. The Claims Special Investigator role supports claims staff to investigate potential fraud as well as provide peripheral support in managing ISO claims inquiries, locating relevant parties, and providing training to claims staff in industry trends pertaining to SIU. In the fast-pac...

Pharmacy Investigator - Special Investigations Unit Requisition ID 142778 Business Overview At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely ha...

Dental Investigator- Special Investigations Unit Requisition ID 146441 Business Overview At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have ...

Job Summary: The Investigator, Special Investigations Unit (SIU) is a key contributor to the Plan’s member and provider fraud, waste, and abuse (FWA) detection, investigation, remediation, and prevention efforts. The Investigator utilizes preliminary recommendations provided by the SIU Data Analyst to develop, conduct, resolve, document, and report on investigations of tips, allegations, or data ...

Apply Now Investigator Special Investigations Unit Job Location: Manchester, NH Job Description Job Summary: The Investigator, Special Investigations Unit (SIU) is a key contributor to the Plan’s member and provider fraud, waste, and abuse (FWA) detection, investigation, remediation, and prevention efforts. The Investigator utilizes preliminary recommendations provided by the SIU Data Analyst ...

Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. Conduct investigations of potential waste, abuse, and fraud Document activity on each case and refer issues to the appropriate party Perform data mining ...

Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. Conduct investigations of potential waste, abuse, and fraud Document activity on each case and refer issues to the appropriate party Perform data mining ...

Role: Dental Investigator - Special Investigations Unit Assignment: Special Investigations Unit Location: Green Bay, WI or Louisville KY, Virtual We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing per...

Job Summary: The Investigator, Special Investigations Unit (SIU) is a key contributor to the Plan’s member and provider fraud, waste, and abuse (FWA) detection, investigation, remediation, and prevention efforts. The Investigator utilizes preliminary recommendations provided by the SIU Data Analyst to develop, conduct, resolve, document, and report on investigations of tips, allegations, or data ...

AMENDED (Those who previously applied need not re-apply) Position Summary: The Confidential Investigator will have wide latitude for independent action and decision, in the performance of highly confidential and sensitive investigations into allegations of corruption, misconduct, and/or other illegal, unethical, or improper activity by Department of Education employees. The Confidential Investig...

Role: Pharmacy Investigator - Special Investigations Unit Assignment: Special Investigations Unit Location: Green Bay, WI or Louisville KY, Virtual We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing p...

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Special Investigations Unit Investigator - Global Security & Military Affairs-150036781 Job Description JPMorgan Chase & Co. (NYSE: JPM) is a leading global financial services firm with assets of $2.4 trillion and operations worldwide. The Firm is a leader in investment banking, financial services for consumers, small business and commercial banking, financial transaction processing, asset manag...

About Us AmeriHealth Caritas is growing! We are the nation’s leading provider of health care solutions for the underserved—a mission-driven organization that has helped people in need for 30 years. Our companies positively impact the lives of nearly 5 million individuals in 13 states. As we expand, AmeriHealth Caritas is seeking talented, passionate associates to join our team. Together we can b...