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Insurance Siu Jobs in Houston, TX (NOW HIRING)

VRC Investigations

Surveillance Investigator

Houston, TX · On-site

$20.50 - $25.25/hr

... insurance fraud. The surveillance investigator position is a field based, hourly, and non-exempt ... Opportunities for advancement include Management, SIU Investigations, and other operational ...

VRC Investigations

Surveillance Investigator

Houston, TX · On-site

$20 - $25/hr

... insurance fraud. The surveillance investigator position is a field based, hourly, and non-exempt ... Opportunities for advancement include Management, SIU Investigations, and other operational ...

Allied Universal

Surveillance Investigator

Houston, TX · On-site

$20.50 - $25.25/hr

... insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and ...

Allied Universal

Surveillance Investigator

Houston, TX · On-site

$20.50 - $25.25/hr

... insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and ...

Sedgwick

Consumer Care Advocate

Houston, TX · On-site

... Insurance Consumer Care Advocate PRIMARY PURPOSE : To provide high quality service to both internal ... Provides referrals to legal, utilization review, pharmacy, and Special Investigations Unit (SIU) as ...

Iatinsurancegroup

Claims Major Case Director

Houston, TX · On-site +1

$92K - $130K/yr

IAT Insurance Group has an immediate need for a Major Case Unit Director that can report to one of ... Identifies and addresses subrogation/contribution/SIU opportunities. * Sets accurate/timely loss ...

The Whiteside Agency

Inside Auto Appraiser

Houston, TX

$63K - $105K/yr

Subrogation, SIU, etc.). * Effectively manages work assignments and referrals. * In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be ...

Cna

Claims Consultant, Life Sciences

Houston, TX

... SIU resources for further investigation. * Achieves quality standards by appropriately managing ... Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and ...

MSCCN

Inside Auto Appraiser - Atlanta, GA

Houston, TX · On-site

$60K - $75K/yr

Subrogation, SIU, etc.). Effectively manages work assignments and referrals. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be ...

New

MSCCN

Inside Auto Appraiser - Houston, TX

Houston, TX · On-site

$60K - $75K/yr

Subrogation, SIU, etc.). Effectively manages work assignments and referrals. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be ...

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All JobsInsurance Siu JobsInsurance Siu Jobs in Houston, TX

Insurance Siu information

See Houston, TX salary details

$18.6K

$71.3K

$105.5K

How much do insurance siu jobs pay per year?

As of Aug 24, 2026, the average yearly pay for insurance siu in Houston, TX is $71,317.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,800.00 and $95,500.00 per year, depending on experience, location, and employer.

What is an insurance SIU?

An Insurance SIU (Special Investigations Unit) job involves investigating potentially fraudulent insurance claims to prevent financial losses for the company. SIU investigators analyze claims, review evidence, interview witnesses, and collaborate with law enforcement when necessary. Their goal is to detect fraud schemes such as staged accidents, false injury claims, or exaggerations of damages. These professionals must have investigative skills, knowledge of insurance regulations, and sometimes a background in law enforcement or claims adjusting.

What does an insurance SIU investigator do?

Insurance SIU Investigators spend their days reviewing claims flagged for potential fraud, conducting interviews with claimants and witnesses, collecting and analyzing evidence, and preparing detailed investigative reports. They often collaborate closely with claims adjusters, legal teams, and occasionally law enforcement agencies to ensure thorough case handling. Investigators may conduct fieldwork, including site visits or surveillance, as part of gathering information for their cases. This dynamic role balances office work with investigative activities, requiring strong time management and adaptability to shifting priorities.

What are the key skills and qualifications needed for an insurance SIU position?

To excel as an Insurance SIU (Special Investigations Unit) Investigator, you need a solid background in insurance practices, fraud detection methodologies, and investigative techniques, often supported by a relevant degree or law enforcement experience. Familiarity with case management software, data analysis tools, and certifications such as the Certified Fraud Examiner (CFE) designation are highly beneficial. Outstanding analytical thinking, attention to detail, and effective communication skills set top performers apart in this field. These abilities are crucial for identifying fraudulent activities, compiling strong cases, and ensuring the integrity of insurance operations.

What are the most commonly searched types of Insurance Siu jobs in Houston, TX?

The most popular types of Insurance Siu jobs in Houston, TX are:

What are popular job titles related to Insurance Siu jobs in Houston, TX?

For Insurance Siu jobs in Houston, TX, the most frequently searched job titles are:

What job categories do people searching Insurance Siu jobs in Houston, TX look for?

The top searched job categories for Insurance Siu jobs in Houston, TX are:

What cities near Houston, TX are hiring for Insurance Siu jobs?

Cities near Houston, TX with the most Insurance Siu job openings:

Insurance Siu jobs near you
Infographic showing various Insurance Siu job openings in Houston, TX as of August 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 58% In-person, 4% Hybrid, and 38% Remote job distribution, with an average salary of $71,317 per year, or $34.3 per hour.

Medical Compliance Auditor

Texas Children's Hospital

Bellaire, TX

Full-time

Re-posted 4 days ago

Texas Children's Hospital rating

8.3

Company rating: 8.3 out of 10

Based on 176 frontline employees who took The Breakroom Quiz

72nd of 1,063 rated hospitals

Job description

We are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria.

Think you've got what it takes?

Job Duties & Responsibilities 
   Assess the treatment plan, clinical information, and medical necessity of all requested services 
   Utilizes established criteria to appropriately review billed services within established timeframe required. 
   Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. 
   Refers case failing medical necessity criteria to the Special Investigations Unit (SIU) Director and SIU Workgroup for review and a recommendation for action. 
   Telephonic follow-up with the provider's office to request additional information as needed. 
   Completes timely entry of information into electronic file including a chart with detailed findings of the review and a report summarizing the results of the audit. 
   Evaluate benefit coverage and regulatory guidelines pertinent to decision making for each investigation. 
   Perform Clinical and Coding Review on Medical Claim Appeals. 
   Assess and process all education and recoupment letters after Special Investigative Committee review decision. 
   Facilitates provider communication and education. 
   Liaisons with internal staff members. 
   Perform Clinical Review and make recommendation on Audit Pass/Fail. 
   Ongoing assessment for quality indicators and concerns.


Skills & Requirements 
    Required Associate's Degree in Nursing  or
    Technical Diploma in Vocation Nursing
    Preferred Bachelor's Degree in Nursing
    Required LVN - Lic- Licensed Vocational Nurses Texas Board of Nursing or Nursing Licensure Compact or 
    RN-Lic-Registered Nurses Texas Board of Nursing or Nursing Licensure Compact 
    Preferred CPC-Cert-Cert Professional Coder Americal Academy of Professional Coders
     Required 3 years Clinical experience in the applicable field according to the license (LVN or RN) 
     4 years of Medical Auditing experience.
 

Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

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