Provides investigative support for special investigation unit (SIU) activities specific to medical ... Critical-thinking, problem-solving and analytical skills. * Ability to prioritize and manage ...
Provides investigative support for special investigation unit (SIU) activities specific to medical ... Critical-thinking, problem-solving and analytical skills. * Ability to prioritize and manage ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Regulatory Affairs Director - Hybrid
Bronx, NY · Hybrid
$156K - $206K/yr
... contracts, compliance, surveys, audits, investigations, reporting, plan development and renewal ... Lead activities of the Special Investigation Unit (SIU), including SIU reporting and internal ...
Regulatory Affairs Director - Hybrid
Bronx, NY · Hybrid
$156K - $206K/yr
... contracts, compliance, surveys, audits, investigations, reporting, plan development and renewal ... Lead activities of the Special Investigation Unit (SIU), including SIU reporting and internal ...
Regulatory Affairs Director - Hybrid
Bronx, NY · Hybrid
$156K - $206K/yr
... contracts, compliance, surveys, audits, investigations, reporting, plan development and renewal ... Lead activities of the Special Investigation Unit (SIU), including SIU reporting and internal ...
Regulatory Affairs Director - Hybrid
Bronx, NY · Hybrid
$156K - $206K/yr
... contracts, compliance, surveys, audits, investigations, reporting, plan development and renewal ... Lead activities of the Special Investigation Unit (SIU), including SIU reporting and internal ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Supports other SIU investigators and analysts with their cases by providing clinical information ... A general understanding of contract benefits, electronic data processing systems, and ...
Provides investigative support for special investigation unit (SIU) activities specific to medical ... Critical-thinking, problem-solving and analytical skills. * Ability to prioritize and manage ...
Provides investigative support for special investigation unit (SIU) activities specific to medical ... Critical-thinking, problem-solving and analytical skills. * Ability to prioritize and manage ...
Commercial Property Claims Adjuster II
$73K - $100K/yr
... claim notices, policies, contracts, statutes, lawsuits, and reports to confirm coverage ... Documents claim activity, summaries, and reserve analyses in the claim system and establishes ...
Commercial Property Claims Adjuster II
$73K - $100K/yr
... claim notices, policies, contracts, statutes, lawsuits, and reports to confirm coverage ... Documents claim activity, summaries, and reserve analyses in the claim system and establishes ...
RAC, MAC, UPIC, SMRC, CERT, OIG, Medicare Advantage payment integrity, commercial payer SIU, and ... Analytics, Technology & Prevention • Define data and reporting requirements; partner with Revenue ...
Quick apply
RAC, MAC, UPIC, SMRC, CERT, OIG, Medicare Advantage payment integrity, commercial payer SIU, and ... Analytics, Technology & Prevention • Define data and reporting requirements; partner with Revenue ...
PI Medical Coding Reviewer III (CPC, RHIT or RHIA required)
Dayton, OH · On-site +1
$62K - $100K/yr
Coordinate the training of new and existing claims analyst staff to increase recognition of ... Refer suspected Fraud, Waste, or Abuse to the SIU when identified in normal course of business.
PI Medical Coding Reviewer III (CPC, RHIT or RHIA required)
Dayton, OH · On-site +1
$62K - $100K/yr
Coordinate the training of new and existing claims analyst staff to increase recognition of ... Refer suspected Fraud, Waste, or Abuse to the SIU when identified in normal course of business.
Coordinate the training of new and existing claims analyst staff to increase recognition of ... Refer suspected Fraud, Waste, or Abuse to the SIU when identified in normal course of business.
Coordinate the training of new and existing claims analyst staff to increase recognition of ... Refer suspected Fraud, Waste, or Abuse to the SIU when identified in normal course of business.
Risk Management Specialist
Villa Park, IL · On-site
$70K - $85K/yr
Conduct pre-contract due diligence and ongoing vendor risk assessments. * Facilitate annual vendor ... Special Investigations Unit (SIU) Coordination * Coordinate investigations of suspected fraudulent ...
Quick apply
Risk Management Specialist
Villa Park, IL · On-site
$70K - $85K/yr
Conduct pre-contract due diligence and ongoing vendor risk assessments. * Facilitate annual vendor ... Special Investigations Unit (SIU) Coordination * Coordinate investigations of suspected fraudulent ...
... analytics, and supporting fraud mitigation activities within a current contract. The position ... Prior leadership of a Special Investigations Unit (SIU) or equivalent function in a health plan ...
... analytics, and supporting fraud mitigation activities within a current contract. The position ... Prior leadership of a Special Investigations Unit (SIU) or equivalent function in a health plan ...
Director of TPA Operations
$100K - $120K/yr
Direct benefit configuration and claims system governance, translating health plan contracts ... Drive data-informed performance management and reporting, leveraging analytics to monitor SLAs ...
Director of TPA Operations
$100K - $120K/yr
Direct benefit configuration and claims system governance, translating health plan contracts ... Drive data-informed performance management and reporting, leveraging analytics to monitor SLAs ...
Director of TPA Operations
Miami, FL · On-site
$100K - $120K/yr
... contracts, reimbursement methodologies, and benefit designs into scalable, accurate system logic ... reporting, leveraging analytics to monitor SLAs, KPIs, utilization trends, and operational ...
Director of TPA Operations
Miami, FL · On-site
$100K - $120K/yr
... contracts, reimbursement methodologies, and benefit designs into scalable, accurate system logic ... reporting, leveraging analytics to monitor SLAs, KPIs, utilization trends, and operational ...
Senior Auto Claims Adjuster
Phoenix, AZ · Hybrid
$54K - $92K/yr
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills ... Contract Interpretation experience: Liability & Physical Damage Coverage and Uninsured/Underinsured ...
Quick apply
Senior Auto Claims Adjuster
Phoenix, AZ · Hybrid
$54K - $92K/yr
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills ... Contract Interpretation experience: Liability & Physical Damage Coverage and Uninsured/Underinsured ...
Property Adjuster Specialist Field
$69K - $133K/yr
Confirm/analyze coverage, recognize liability exposure, and negotiate equitable settlements in ... Identify coverage concerns, review prior loss history, and create Special Investigation Unit (SIU ...
Property Adjuster Specialist Field
$69K - $133K/yr
Confirm/analyze coverage, recognize liability exposure, and negotiate equitable settlements in ... Identify coverage concerns, review prior loss history, and create Special Investigation Unit (SIU ...
Contract Siu Analyst information
See salary details
$32K - $41.2K
2% of jobs
$41.2K - $50.5K
7% of jobs
$50.5K - $59.7K
9% of jobs
$64.5K is the 25th percentile. Wages below this are outliers.
$59.7K - $68.9K
12% of jobs
$68.9K - $78.1K
17% of jobs
The median wage is $79.7K / yr.
$78.1K - $87.4K
16% of jobs
$94.8K is the 75th percentile. Wages above this are outliers.
$87.4K - $96.6K
15% of jobs
$96.6K - $105.8K
5% of jobs
$105.8K - $115K
9% of jobs
$115K - $124.3K
4% of jobs
$124.3K - $133.5K
3% of jobs
$32K
$84.2K
$133.5K
How much do contract siu analyst jobs pay per year?
What is the difference between Contract Siu Analyst vs Contract Underwriter?
| Aspect | Contract Siu Analyst | Contract Underwriter |
|---|---|---|
| Required Credentials | Bachelor's degree, industry certifications (e.g., CPCU, ARM) | Bachelor's degree, insurance licenses, underwriting certifications |
| Work Environment | Office-based, analytical, risk assessment | Office or remote, risk evaluation, policy approval |
| Employer & Industry Usage | Insurance companies, consulting firms | Insurance carriers, brokerage firms |
| Common Search & Comparison | Yes | Yes |
The Contract Siu Analyst and Contract Underwriter roles both operate within the insurance industry, requiring similar credentials and working environments. While the Siu Analyst focuses on analyzing claims and risk assessments, the Underwriter primarily evaluates and approves insurance policies. Both roles are essential for risk management and are often sought by insurance companies and related firms.
What is a Contract SIU Analyst?
How does a Contract SIU Analyst typically collaborate with internal and external stakeholders during investigations?
What are the key skills and qualifications needed to thrive as a Contract SIU Analyst, and why are they important?

Full-time
Posted 2 days ago
Molina Healthcare rating
8.0
Based on 192 frontline employees who took The Breakroom Quiz
146th of 260 rated insurance
Job description
- Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies.
- Reviews post-pay claims against corresponding medical records to determine accuracy of claims payments.
- Manages documents and prioritizes caseloads to ensure timely turnaround.
- Ensures adherence to applicable state/federal/internal policies, Current Procedural Terminology (CPT) guidelines and provider contract requirements.
- Devises clinical summary post-review.
- Communicates and participates in meetings related to cases.
- Completes medical review to facilitate referral to law enforcement or payment recovery.
- Supports investigation work as necessary and required by the regulatory agency.
- At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience.
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified
- Critical-thinking, problem-solving and analytical skills.
- Ability to prioritize and manage multiple tasks.
- Ability to work in a team setting.
- Strong verbal/written communication skills, and presentation skills.
- Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
- In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
- Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations.
- Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs.
- Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems.
- Ability to research and interpret regulatory requirements.
- Certified Professional Compliance Officer (CPCO).
- Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI).
- Experience working in group health insurance, particularly within claims processing or operations.
- Working knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.).
- Experience with claims processing systems.
- Ability to use Microsoft Excel/Access platforms working with large quantities of data.
- Ability to answer questions, identify trends and patterns, and present findings.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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About Molina Healthcare
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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980