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Remote Siu Insurance Jobs in Missouri (NOW HIRING)

Jobgether

Experience with HL7 v2.x message types (ADT, ORM, ORU, SIU, MDM), routing, transformation, and ... insurance/payer APIs. Benefits: * Remote work opportunity with flexibility to collaborate in a ...

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Remote Siu Insurance information

What is the difference between Remote Siu Insurance vs Remote Claims Adjuster?

AspectRemote Siu InsuranceRemote Claims Adjuster
CertificationsInsurance licenses, SIU-specific trainingAdjuster licenses, state-specific certifications
Work EnvironmentInsurance company, SIU department, remoteInsurance companies, third-party firms, remote
Industry UsageInsurance industry, fraud investigationInsurance industry, claims assessment
Job FocusInvestigating insurance fraud, SIU casesEvaluating claims, determining payouts

Remote Siu Insurance specialists focus on investigating insurance fraud cases remotely, requiring specific SIU training and licenses. Remote Claims Adjusters handle claims assessments and payouts, often with similar licensing. While both roles are remote and within the insurance industry, their core responsibilities differ: fraud investigation versus claims evaluation.

What are the key skills and qualifications needed to thrive as a Remote SIU (Special Investigations Unit) Insurance Investigator, and why are they important?

To thrive as a Remote SIU Insurance Investigator, you need a strong background in investigative techniques, insurance claims processes, and typically a relevant bachelor's degree or equivalent experience. Familiarity with case management software, fraud detection tools, and secure communication platforms is essential. Excellent analytical thinking, attention to detail, and strong written and verbal communication skills help you stand out in this role. These skills are crucial for accurately identifying and documenting fraudulent activity while maintaining compliance and protecting company assets.

What is a Remote SIU Insurance Investigator?

A Remote SIU (Special Investigations Unit) Insurance Investigator is a professional who works remotely to detect, investigate, and help prevent insurance fraud. They analyze claims for suspicious activity, gather evidence, interview claimants and witnesses, and work with law enforcement when necessary. Remote SIU investigators utilize digital tools and databases to conduct their investigations from home or another remote location instead of a traditional office. Their work is crucial for insurance companies to minimize fraudulent losses and ensure legitimate claims are processed correctly.

What are the typical challenges faced by Remote SIU Insurance Investigators, and how can they be addressed?

Remote SIU (Special Investigations Unit) Insurance Investigators often encounter challenges such as limited access to on-site evidence and coordinating effectively with field investigators or law enforcement. To overcome these, investigators leverage digital tools for secure document review, conduct interviews via video calls, and maintain thorough, organized records. Success also depends on strong communication skills and a disciplined approach to managing caseloads independently while collaborating closely with colleagues and external partners.
What are popular job titles related to Remote Siu Insurance jobs in Missouri? For Remote Siu Insurance jobs in Missouri, the most frequently searched job titles are:
What job categories do people searching Remote Siu Insurance jobs in Missouri look for? The top searched job categories for Remote Siu Insurance jobs in Missouri are:
What cities in Missouri are hiring for Remote Siu Insurance jobs? Cities in Missouri with the most Remote Siu Insurance job openings:
Remote Siu Insurance jobs near you
FWA Analyst Intern

FWA Analyst Intern

Healthcare Fraud Shield

Chesterfield, MO • On-site, Remote

Full-time, Part-time, Internship

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

FWA Analyst Intern
Department: SIU
Employment Type: Internship
Location: Headquarters
Description
Healthcare Fraud Shield is seeking a part-time Fraud, Waste and Abuse (FWA) Analyst Intern for our health care Fraud, Waste and Abuse software platform. You will work with our Special Investigations Unit and IT teams on researching FWA schemes, testing, FWA validation and more. In this role, you should have a keen eye for detail and excellent communication skills. If you are also competent in executing test cases and are passionate about quality then this is the job for you.
Healthcare Fraud Shield provides a competitive salary. Benefits packages are not available to part-time employees.
Key Responsibilities
  • Use knowledge of Fraud, Waste and Abuse (FWA) to research, test and identify effective alerts and algorithms targeting FWA detection and prevention on claims
  • Proactively analyzes and tests output of FWA schemes and enhancements to existing FWA schemes
  • Understanding of pharmacy and medical claims data analysis and quality monitoring
  • Maintain alert and policy knowledgebase
  • Research supporting documentation for knowledgebases by client
  • Execute test cases and analyze results
  • Demonstrated aptitude for problem solving and debugging
  • Identify and troubleshoot issues discovered during testing and reported by customers
  • Work with cross-functional teams to ensure quality throughout the software development lifecycle
  • Satisfies all applicable requirements imposed by applicable Company customers, clients, or business partners, with respect to the relationship and role
  • Understands and complies with all company Privacy and Security standards
  • Other duties as assigned

Skills, Knowledge and Expertise
  • Knowledge of healthcare Fraud, Waste and Abuse (FWA)
  • Knowledge of health care, insurance, medical terminology, CPT, HCPCS, DRG, Revenue, ICD-10
  • Ability to document and troubleshoot errors
  • Excellent communication skills both verbally and written
  • Attention to detail
  • Analytical mind and problem-solving aptitude
  • Excellent troubleshooting and problem solving skills
  • Ability to communicate instructions in a clear and concise manner
  • Comfortable multitasking in fast paced environment
  • Able to work independently as well as part of a dynamic team

Preferred Skills:
  • Strong communication and listening skills
  • Strong analytical skills
  • Strong computer skills
  • Detail oriented

Benefits
  • Medical, Dental & Vision insurance
  • 401(k) retirement savings with employer match
  • Vacation and sick paid time off
  • 8 paid holidays
  • Paid maternity/paternity leave
  • Disability & Life insurance
  • Flexible Spending Account (FSA)
  • Employee Assistance Program (EAP)
  • Professional and career development initiatives
  • Remote work eligible

REMOTE WORK REQUIREMENTS
  • Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.

Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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