SIU Field Investigator Job at Geico (Melbourne)

Senior SIU Field Investigator

At GEICO, we offer a rewarding career where your ambitions are met with endless ...

Location

United States , Fort Lauderdale; Miami; Plantation

Salary:

Not provided

Geico

Expiration Date

Until further notice

Requirements

Qualified candidates must possess a strong investigative background
Minimum of 3-5 years documented fraud investigative experience in areas of SIU and/or law enforcement experience
For law enforcement experience, prior detective-level experience required
Prior field investigative statements
Fact finding details to include complex investigations
Exceptional verbal and written communication skills
Proficiency in Microsoft Word and Outlook with working knowledge of Excel and PowerPoint
Typing of a minimum 35 WPM
Candidate must have a valid Driver’s License and will be subject to background and driving record checks

Job Responsibility

Conduct investigations of suspected cases of fraud or other illegal activities against the Company, including interviewing, database inquiries, taking statements, and locating sources of information and witnesses
Evaluating information to determine its credibility
Referring and coordinating investigation assignments to outside agencies
Providing training and support to all departments in the claims handling process
Participate in SIU industry meetings

What we offer

Premier Medical, Dental and Vision Insurance with no waiting period
Paid Vacation, Sick and Parental Leave
401(k) Plan
Tuition Reimbursement
Paid Training and Licensures
Mental healthcare as well as fertility and adoption assistance
Workplace flexibility
GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year

Fulltime

Senior Director of Operations - PACE

Advance Your Career in Insurance Claims with Allied Universal® Compliance and In...

Location

United States , Dallas

Salary:

Not provided

Allied Universal®

Expiration Date

Until further notice

Requirements

Must possess one of the following: Bachelor’s degree in Healthcare Administration, Nursing, or Business
Associate’s degree in Healthcare Administration, Nursing, or Business and a minimum of eight (8) years of related experience in a healthcare leadership role
Minimum of three (3) years managing or directing an SIU insurance investigation program
Minimum of six (6) years of experience in a progressive healthcare leadership role
Ability to think strategically, make timely decisions and implement change
Ability to remain highly productive in a changing environment, possess strong attention to detail and well-developed organizational skills, and maintain a high level of discretion
Demonstrated proficiency in using subscription databases to search for relevant information on investigative assignments in support of the technical and professional staff of the SIU
Outstanding written and oral communication skills
Proficiency in Microsoft Outlook, Excel, Word, and PowerPoint

Job Responsibility

Oversight of SIU (Special Investigative Unit) Investigations team associated with the PACE contract
Use independent judgment to define and confirm client objectives (including due dates) on all new, reopen, and investigative referral cases
Provide consultation to the client using independent discretion to develop and implement an efficient, effective, and ethical investigation of an insurance claim
Ensure adherence to clear guidelines regarding company policies on privacy, compliance, and ethics
Ensure independently that the investigators assigned to complete the investigative tasks requested by the client have been given clear instruction on the client’s expectations at the time the case is approved
Maintain quality control after investigation is completed, ensuring that all client’s objectives have been addressed and achieved, and the billing applied to this work product falls within the standard billing schedule or client contract rates
Ensure team meets “reopen” sales goals on a monthly basis, creating accurate funding records for all items billable to the client
Use sound management, discretion, and independent judgment to resolve conflicts between clients and/or investigators
Handle customer complaints (negotiating as needed) and forward field operational issues to appropriate Vice President as needed
Provide daily updates to the clients within one business day after an investigative task has been completed, or per the client’s updating protocols set forth in a contract (if applicable)

What we offer

Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law
Employee Assistance Program
Employee Discount Program
Tuition Discount Program
Training & Career Development Programs

Fulltime

Director, Compliance on Special Investigations Unit and Fraud, Waste and Abuse

The Director, Compliance on Special Investigations and Fraud, Waste and Abuse (F...

Location

United States , Los Angeles

Salary:

135136.00 - 216218.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Criminal Justice or Related Field
At least 7 years of experience in healthcare compliance, fraud investigations, law enforcement, or related field
At least 5 years of experience in leading teams, projects, initiatives, or cross-functional groups
Demonstrated experience managing complex investigations in a managed care or healthcare environment
Experience in coordinating with external regulators and law enforcement agencies
Proven knowledge of CMS, DHCS, DMHC, OIG, and DOJ regulatory frameworks governing FWA programs
Strong investigative skills, including evidence gathering, interviewing, and case documentation
Demonstrated success in leading complex, multi-party investigations with integrity and discretion
Excellent communication skills
Strong organizational and project management abilities

Job Responsibility

Lead L.A. Care’s Special Investigations Unit (SIU) in overseeing internal and external investigations into fraud, waste, abuse, and compliance violations
Drive the design, implementation, and continuous improvement of the Fraud, Waste, and Abuse (FWA) program
Ensure effective case intake, triage, investigation, tracking, and resolution processes
Develop and support enterprise policies, procedures, and training programs supporting FWA prevention, detection, and response
Direct and oversee investigations into allegations of non-compliance, ethical violations, or fraudulent behavior
Partner with Legal, Compliance, and Human Resources on sensitive internal investigations
Ensure timely and accurate reporting of SIU/FWA activity to external agencies
Lead enterprise readiness for external audits, regulatory inquiries, and enforcement actions
Conduct strategic planning to use resources to meet departmental and Enterprise-wide goals
Monitor investigative trends, emerging risks, and regulatory developments

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Senior Field Security Investigator

We have an exciting opportunity to join the SIU team as a Senior Field Security ...

Location

United States , Charlotte

Salary:

Not provided

Geico

Expiration Date

Until further notice

Requirements

An associate or bachelor’s degree in criminal justice or a related field
Five years of insurance claims investigative experience (includes TCR1, TCR2, CU, PIP technical and/or PIP litigation desk experience), professional investigation experience with law enforcement agencies
Seven years of professional investigation experience involving economic or insurance related matters
Experience handling in-person or phone statements from various parties in an investigation
Ability to gather a broad range of evidence related to an investigation and draw conclusions
Demonstrated ability to organize and prioritize investigative volume workloads and stressful situations
Must be able to always maintain a professional attitude and appearance
Must be able to document files in a clear, concise, professional written manner
Must be able to obtain and maintain a valid driver’s license, certifications and permits
Must be able to lift and carry materials and equipment

Job Responsibility

Conduct investigations of suspected cases of fraud or other illegal activities against the Company
Interviewing, database inquiries, taking statements, and locating sources of information and witnesses
Evaluating information to determine its credibility
Referring, and coordinating investigation assignments to outside agencies
Providing training and support to all departments in the claims handling process

What we offer

Comprehensive Total Rewards program
401K savings plan vested from day one that offers a 6% match
Performance and recognition-based incentives
Tuition assistance
Access to additional benefits like mental healthcare as well as fertility and adoption assistance
Workplace flexibility
GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year

Fulltime

Surveillance Investigator

Allied Universal® is hiring a Surveillance Investigator. The Surveillance Invest...

Location

United States , Lansing

Salary:

Not provided

Allied Universal®

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Post offer, must be able to successfully complete the Allied Universal Investigations' training/orientation course
Minimum of one (1) year of verifiable work experience, preferably involving investigations or other protective service-related field
Flexibility to work varied and irregular hours/days including weekends and holidays
Ability to type reports in Microsoft Word format with minimal grammatical and punctuation errors
Proficient in utilizing laptop computers, video cameras and cell phones
Capable of maintaining focus and multitasking effectively in a dynamic environment
Demonstrated ability to manage stressful situations with composure and professionalism
Ability to work in a very independent environment
Must possess a valid driver's license with at least one year of driving experience

Job Responsibility

Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability
Utilize various surveillance techniques and equipment to monitor subjects covertly
Document and report observations, activities, and any relevant information in a clear and concise manner
Collaborate with other investigators and law enforcement agencies as needed to gather information and coordinate efforts
Maintain confidentiality and adhere to legal and ethical standards in conducting surveillance operations

What we offer

Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly
Auto and travel allowances

Fulltime

Surveillance Investigator

Location

United States , Livermore

Salary:

20.00 - 24.00 USD / Hour

Allied Universal®

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Post offer, must be able to successfully complete the Allied Universal Investigations' training/orientation course
Minimum of one (1) year of verifiable work experience, preferably involving investigations or other protective service-related field
Flexibility to work varied and irregular hours/days including weekends and holidays
Ability to type reports in Microsoft Word format with minimal grammatical and punctuation errors
Proficient in utilizing laptop computers, video cameras and cell phones
Capable of maintaining focus and multitasking effectively in a dynamic environment
Demonstrated ability to manage stressful situations with composure and professionalism
Ability to work in a very independent environment
Must possess a valid driver's license with at least one year of driving experience

Job Responsibility

Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability
Utilize various surveillance techniques and equipment to monitor subjects covertly
Document and report observations, activities, and any relevant information in a clear and concise manner
Collaborate with other investigators and law enforcement agencies as needed to gather information and coordinate efforts
Maintain confidentiality and adhere to legal and ethical standards in conducting surveillance operations

What we offer

Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly
unused vacation is only paid out where required by law

Fulltime

Director, Fraud Prevention and Program Oversight

Community First Health Plans, Inc. (Community First) is an HMO providing health ...

Location

United States , San Antonio

Salary:

40.87 - 91.35 USD / Hour

University Health

Expiration Date

Until further notice

Requirements

Bachelor’s degree is required in accounting, business administration or related field
Experience in interpretation of regulatory agency policies is preferred
Experience with anti-fraud detection and prevention is required
Three years of supervisory experience is preferred
Experience with SEC SOX and/or NAIC MAR audits, and Enterprise Risk Management (ERM) is highly desirable
At least three years of professional audit experience is required

Job Responsibility

Leads the organization’s efforts to prevent, detect, investigate, and remediate fraud, waste, and abuse (FWA) across all product lines
Ensures program integrity by setting organizational standards, strengthening internal controls, and overseeing the Special Investigations Unit (SIU) operations, payment integrity analytics, and vendor oversight
Ensures program integrity by setting enterprise standards, strengthening internal controls, and overseeing SIU operations, payment integrity analytics, vendor oversight, and internal auditing functions

Fulltime

New

Assistant Director of Video Services

K-State Athletics is seeking qualified applicants for an Assistant Director of V...

Location

United States , Manhattan

Salary:

47500.00 - 50000.00 USD / Year

Kansas State University

Expiration Date

Until further notice

Requirements

Bachelor's degree or equivalent combination of education and training beyond high school, with an emphasis in professional video production, broadcast media, sports media, digital media, or a related field
Strong proficiency in Adobe Premiere Pro, Adobe After Effects, and Adobe Photoshop
Bachelor's degree in video production, broadcast media, sports media, communications, or a related field
Minimum of one year of full-time experience in a collegiate or live-event video production environment
Working knowledge of Ross Video Kiva, Expression, and Acuity systems
Daktronics Show Control
EVS Replay systems
and Yamaha audio boards
Strong verbal and written communication skills with the ability to collaborate effectively across departments and production teams
Demonstrated ability to perform in a fast-paced, high-pressure live production environment while meeting deadlines and adapting to last-minute changes with strong attention to detail

Job Responsibility

Plan, develop, edit, organize, and manage creative content for videoboards and other in-venue display systems
Manage all game day control room operations, including production setup, supervision of student and freelance crew members, live event directing, and overall execution of in-venue videoboard productions
Oversee operation and content management of Daktronics display systems across all athletic venues, ensuring proper functionality and timely content updates
Perform additional duties and special projects as assigned

What we offer

Excellent medical, dental and vision health plans
Retirement plan (No Vesting Period!!)
Generous earned leave plan – vacation and sick
Parental leave plan
Term life insurance
Accidental death and dismemberment insurance
Long term disability insurance
Paid KSU designated holidays

Fulltime

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SIU Field Investigator

Job Description

Job Responsibility

Requirements

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