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Contract Siu Analyst Jobs (NOW HIRING)

Massgeneralbrigham

SIU Fraud Investigator

Somerville, MA · On-site

$79K - $115K/yr

In addition to performing analytics, the Data Analyst will be required to conduct preliminary research of identified providers or members, including public records, contracts, and social media ...

AlphaStaffHCM

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 ...

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Contract Siu Analyst information

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$84.2K

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How much do contract siu analyst jobs pay per year?

As of Jul 16, 2026, the average yearly pay for contract siu analyst in the United States is $84,207.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,000.00 and $98,500.00 per year, depending on experience, location, and employer.

What is the difference between Contract Siu Analyst vs Contract Underwriter?

AspectContract Siu AnalystContract Underwriter
Required CredentialsBachelor's degree, industry certifications (e.g., CPCU, ARM)Bachelor's degree, insurance licenses, underwriting certifications
Work EnvironmentOffice-based, analytical, risk assessmentOffice or remote, risk evaluation, policy approval
Employer & Industry UsageInsurance companies, consulting firmsInsurance carriers, brokerage firms
Common Search & ComparisonYesYes

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?

A Contract SIU (Special Investigations Unit) Analyst is a professional who investigates potential fraud, waste, or abuse within insurance claims or contracts. They work for insurance companies or healthcare organizations to analyze data, identify suspicious patterns, and support investigations into fraudulent activity. Contract SIU Analysts may be hired on a contract basis rather than as full-time employees, providing flexibility for organizations needing specialized fraud detection skills. Their work helps ensure compliance with regulations and protects the financial integrity of their organization.

How does a Contract SIU Analyst typically collaborate with internal and external stakeholders during investigations?

As a Contract SIU Analyst, collaboration is a key part of the job. You’ll frequently work with claims adjusters, legal teams, and external investigators to gather facts, review documentation, and assess potential fraud. Communication with law enforcement or regulatory bodies may also be needed, depending on the case. Building strong relationships and maintaining clear, accurate records is essential to ensure investigations proceed efficiently and findings are well-supported.

What are the key skills and qualifications needed to thrive as a Contract SIU Analyst, and why are they important?

To excel as a Contract SIU Analyst, you need a solid understanding of insurance claims, fraud detection, and investigative techniques, typically supported by a bachelor’s degree in criminal justice, finance, or a related field. Familiarity with case management systems, data analytics tools, and relevant certifications such as CIFI (Certified Insurance Fraud Investigator) is often required. Strong analytical thinking, attention to detail, and effective communication skills help you identify suspicious activity and collaborate with internal and external stakeholders. These skills are crucial for ensuring accurate fraud investigations, minimizing financial losses, and maintaining regulatory compliance.
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Contract Siu Analyst jobs near you
Investigator, Special Investigative Unit Coding-South Carolina

Investigator, Special Investigative Unit Coding-South Carolina

Molina Healthcare

Long Beach, CA

Full-time

Re-posted 9 days ago

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

133rd of 281 rated insurance

Job description

JOB DESCRIPTION
Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informational tips from member benefits and medical records following review of post-payment claims. 
Essential Job Duties
  • 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.
Job Requirements
  • 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.
Preferred Qualifications
  • 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. 
 
To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.
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

Sourced by ZipRecruiter

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

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