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JOB DESCRIPTION
Job Summary
The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is ...

Overview
As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role.
Responsibilities
* Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse.
* Conduct interviews or correspond with pa...

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important...

Looking for a new challenge?
Take a look at our current vacancies. If you see a vacancy that is right for you, we encourage you to apply!
Investigator - Edinburgh
Make a positive difference to financial services
Contract: up to 4 years fixed-term contract
Working hours: full time (35 hours pw) and part time (28 hours pw)
Salary: £31,238pa (full time), £24,990pa (part time)
Reporting to: O...

ARIZONA BOARD OF NURSING
The mission of the Arizona State Board of Nursing is to protect and promote the welfare of public by ensuring that each person holding a nursing license or certificate is competent to practice safely. The Board fulfills its mission through the regulation of the practice of nursing and the approval of nursing education programs. The mission, derived from the Nursi...

JOB DESCRIPTION
Job Summary
The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is ...

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important...

About the Company
Founded in 2018 by professors of Yale University and Columbia University, CertiK is a pioneer in blockchain security, utilizing best-in-class AI technology to secure and monitor blockchain protocols and smart contracts. CertiK’s mission is to secure the cyber world. Starting with blockchain, CertiK applies cutting-edge innovations from academia into enterprise, enabling missio...

LOCATION: Remote – must live in or/near Vaya’s catchment area. Must also reside in North Carolina or within 40 miles of the NC border.
GENERAL STATEMENT OF JOB
The Special Investigator works under the direct supervision of the Special Investigations Operations Manager. The Special Investigator is responsible for identification, investigation and prevention of healthcare fraud, waste ...

Overview
Treliant is an essential consulting firm serving banks, mortgage originators and servicers, fintechs, and other companies providing financial services globally. We are led by practitioners from the industry and the regulatory community who bring deep domain knowledge to help our clients drive business change and address the most pressing compliance, regulatory, and operational challen...

Who Are We?
Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
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Job summary
The NHS Counter Fraud Authority (NHSCFA) is the national body responsible for all matters relating to the prevention, detection and investigation of economic crime across the NHS. Further information about our work and annual plan for delivering this is available on our website.
The NHS Counter Fraud Authority are looking to recruit an experienced Fraud Investigator to work with...

Senior Field Security Investigator
Summary
We have an exciting opportunity to join the SIU team as a Senior Field Security Investigator in the Melbourne/Palm Bay area! As a Senior Field Security Investigator, you will conduct investigations of suspected cases of fraud or other illegal activities against the Company, including interviewing, database inquiries, taking statements, and locating s...

Binance is a leading global blockchain ecosystem behind the world’s largest cryptocurrency exchange by trading volume and registered users. We are trusted by over 250 million people in 100+ countries for our industry-leading security, user fund transparency, trading engine speed, deep liquidity, and an unmatched portfolio of digital-asset products. Binance offerings range from trading and finan...

We have an exciting opportunity to join the SIU team and the Expanding Commercial GEICO Market as a Lead Security Investigator! This is a Remote position. As a Lead Security Investigator on our Commercial Team, you will conduct non-field investigations of suspected Commercial Auto, Commercial Trucking, Multiline, and Auto claims suspected of containing fraud flags and/or other illegal activitie...

Mercury is building a complete finance stack for startups. We work hard to create the easiest and safest banking* experience possible to simplify entrepreneurs' and business owners’ financial lives. We are looking to hire a Senior Risk Investigator on the Card Fraud team to help protect Mercury cardholders from unauthorized activity, all while balancing customer experience.
As a member of the ...

City/State
Tallahassee, FL
Overview
Work Shift
First (Days) (United States of America)
AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Remote Principal Fraud & Abuse Investigator.
The Remote Principal Fraud & Abuse Investigator is responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunitie...

Job Description
Job Summary
The SIU Senior Investigator position is primarily responsible for supporting the day to day operations and initiatives of the Special Investigations Unit (SIU).
Knowledge/Skills/Abilities
• Respond to all allegations of potential FWA. Conduct the investigation of fraudulent, wasteful and abusive activities involving members and providers
• Analyze enrollment data,...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
****POSITION IS REMOTE FOR UNITED STATES***
***CANDIDATES MUST HAVE FRAUD, WASTE AND ABUSE EXPERIENCE***
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