Special Investigations Unit Director jobs in New York

Special Investigations Unit Director oversees the operations for conducting thorough investigations. Develops the strategies for the cross-functional detection and elimination of fraudulent behavior. Being a Special Investigations Unit Director prepares investigative reports and analyses that pertinent to evidence obtained during investigations. May coordinate with outside sources such as law enforcement agencies, and external audit, etc. Requires a bachelor's degree. Additionally, Special Investigations Unit Director typically reports to top management. The Special Investigations Unit Director manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Special Investigations Unit Director typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Special Investigations Unit Medical Reviewer
  • Inland Empire Health Plan
  • Street, NY FULL_TIME
  • What you can expect!

    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

    Under general supervision, the Special Investigations Unit Medical Reviewer (SIU Medical Reviewer) performs reviews of medical records and healthcare claims to substantiate or refute the accuracy and compliance with federal and state regulations and contractual requirements of codes billed to identify coding errors and billing discrepancies in relation to incidents of suspected healthcare fraud, waste, and abuse (FWA) reported to IEHP’s Compliance Special Investigations Unit (SIU).

    Perks

    IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

    • CalPERS retirement
    • 457(b) option with a contribution match
    • Generous paid time off- vacation, holidays, sick
    • State of the art fitness center on-site
    • Medical Insurance with Dental and Vision
    • Paid life insurance for employees with additional options
    • Short-term, and long-term disability options
    • Pet care insurance
    • Flexible Spending Account – Health Care/Childcare
    • Wellness programs that promote a healthy work-life balance
    • Career advancement opportunities and professional development
    • Competitive salary with annual merit increase
    • Team bonus opportunities

    Education & Experience

    • A minimum of two (2) years of experience performing medical reviews of medical records and claims in a healthcare setting
    • Bachelor’s degree in medical billing or medical coding, nursing, healthcare administration, or other related field from an accredited institution required
    • Certified Professional Coder (CPC) required.

    Job Type: Full-time

    Pay: $71,572.80 - $93,038.40 per year

    Benefits:

    • 401(k)
    • 401(k) matching
    • 457(b)
    • Dental insurance
    • Employee assistance program
    • Flexible schedule
    • Flexible spending account
    • Health insurance
    • Health savings account
    • Paid time off
    • Parental leave
    • Professional development assistance
    • Referral program
    • Tuition reimbursement
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Day shift
    • Monday to Friday

    Application Question(s):

    • This position requires onsite work in Rancho Cucamonga, Tu-Th with remote flexibility on Mondays and Fridays. Standard business hours are Mon-Fri, 8am - 5pm. Are you fine with this schedule?

    Education:

    • Bachelor's (Required)

    Experience:

    • medical rcord review and claims: 2 years (Required)

    Ability to Relocate:

    • Rancho Cucamonga, CA 91730: Relocate before starting work (Required)

    Work Location: Hybrid remote in Rancho Cucamonga, CA 91730

  • 1 Day Ago

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Special Investigations Unit (SIU) - Field Investigator
  • Ethos
  • Brooklyn, NY PART_TIME
  • Ethos is looking to hire a part time, experienced Insurance SIU / Claims Field Investigator in the Brooklyn, NY area.Job DescriptionWe are looking for qualified candidates to join our growing team of ...
  • 2 Days Ago

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Private Investigator - Special Investigations Unit (SIU)
  • The Robison Group
  • Queens, NY PART_TIME
  • Qualified candidates are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire damages, auto acc...
  • 11 Days Ago

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Special Investigations Unit (SIU) - Field Investigator
  • Ethos Risk Services
  • Brooklyn, NY PART_TIME
  • Ethos is looking to hire a part time, experienced Insurance SIU / Claims Field Investigator in the Brooklyn, NY area. JOB DESCRIPTION: We are looking for qualified candidates to join our growing team ...
  • 30 Days Ago

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Security Officer Supervisor
  • Buffalo Special Investigations (BSI Security)
  • Buffalo, NY PART_TIME,FULL_TIME
  • Job Description: The Security officer Supervisor will act as a liaison between customers, Operation Managers and security officers. Will supervise site staff and provide coaching, recognition and disc...
  • 4 Days Ago

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Office Clerk
  • Buffalo Special Investigations (BSI Security)
  • Buffalo, NY FULL_TIME,PART_TIME
  • Office Clerk: We are looking for a competent Office Clerk to perform various administrative and clerical tasks to support our business. The office clerk will perform numerous tasks, such as answering ...
  • 5 Days Ago

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Cash Management / FX Operations Consultant
  • Phaxis
  • Jersey City, NJ
  • A global Financial Firm is looking to hire an experienced Cash Management / FX Ops Consultant to join their team in Jers...
  • 6/10/2024 12:00:00 AM

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Cash Management
  • Confidential
  • Jersey City, NJ
  • Cash Management - AVP Work Schedule: Hybrid (on-site 2 days a week) SUMMARY: Support and approves MGeB, Test Key and oth...
  • 6/10/2024 12:00:00 AM

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Employee Relations Director
  • Robert Half
  • Atlanta, GA
  • Robert Half HR Solutions is currently sourcing for a Contract Employee Relations/Investigation Director for our retail c...
  • 6/9/2024 12:00:00 AM

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Cash Management Associate
  • Phyton Talent Advisors
  • Jersey City, NJ
  • Our Client, a Global Investment Bank, is seeking a Cash Management Associate in their Jersey City, NJ location. Responsi...
  • 6/9/2024 12:00:00 AM

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RN Administrative Coordinator Relief- Moses Cone
  • Cone Health
  • Greensboro, NC
  • Overview: Accountable for operational throughput with patients, families, nursing staff and physicians, between departme...
  • 6/9/2024 12:00:00 AM

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Research Regulatory Specialist
  • Georgia Clinical Research LLC
  • Lawrenceville, GA
  • Job Description Job Description Works with the Research Director, Investigators, Study Coordinators, Sponsor Representat...
  • 6/8/2024 12:00:00 AM

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Cash Management- Back Office
  • Mizuho Bank, Ltd.
  • Jersey City, NJ
  • SUMMARY: Support and approves MGeB, Test Key and other payment request transactions for Corporate customers for Mizuho B...
  • 6/8/2024 12:00:00 AM

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Safety Director
  • SAY Group
  • SAY Group is supporting a client who is looking to hire a Safety Director. This is an exciting opportunity for someone w...
  • 6/8/2024 12:00:00 AM

New York is a state in the Northeastern United States. New York was one of the original thirteen colonies that formed the United States. New York covers 54,555 square miles (141,300 km2) and ranks as the 27th largest state by size.[3] The highest elevation in New York is Mount Marcy in the Adirondacks, at 5,344 feet (1,629 meters) above sea level; while the state's lowest point is at sea level, on the Atlantic Ocean. In contrast with New York City's urban landscape, the vast majority of the state's geographic area is dominated by meadows, forests, rivers, farms, mountains, and lakes. Most of...
Source: Wikipedia (as of 04/17/2019). Read more from Wikipedia
Income Estimation for Special Investigations Unit Director jobs
$166,494 to $250,782

Special Investigations Unit Director in Waco, TX
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The Unit is an agency of the Ministry of the Attorney General of Ontario and maintains a close relationship with the government of Ontario.
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