Description : CorVel is seeking a dynamic and experienced Special Investigation Director to lead our Special... Investigations Unit (SIU). This role is critical in safeguarding the integrity of our claims and managed care operations...
for uncovering the truth and protecting vital healthcare resources? Our Special Investigations Unit (SIU) is looking for a skilled... and Impact will include: As an SIU Investigator, you'll be responsible for the full lifecycle of complex FWA investigations...
compliance, and continuous improvement. Reports To: Director of Federal Programs and/or Building Principal Responsibilities.... Perform other duties as assigned by the Director of Federal Programs or Building Principal. Experience: Minimum three (3...
We are adding to our Auto Claims Leadership Team! The Auto Property Damage Director is responsible for oversight... approvals over adjuster authority and the transfer of files to appropriate areas (SIU, Litigation, Total Loss, Subrogation...
Position Summary: We are seeking a Quality Director/Manager to build and oversee the quality and compliance framework... disciplined operations, accurate execution, and adherence to regulatory and payer standards. The Quality Director/Manager...
Position Summary We are seeking an experienced Delivery Manager/Director to oversee the successful execution..., and Operations leaders, the Delivery Manager/Director will manage project execution, resource allocation, risk mitigation...
Litigation Unit Complex Claims Consulting Director. This is an individual contributor role responsible for the direct handling... or SIU resources for further investigation. Achieves quality standards by effectively managing each claim to ensure...
Director is accountable for shaping and driving the performance of the Special Investigations, Subrogation, and Salvage... is to be expected. Provide strategic and operational oversight of the Special Investigations Unit (SIU), Subrogation, and Salvage...
that is responsible for all customer service functions and quality control of the final investigative SIU product. The Senior Director... claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators...
We are adding to our Auto Claims Leadership Team! The Auto Property Damage Director is responsible for oversight... approvals over adjuster authority and the transfer of files to appropriate areas (SIU, Litigation, Total Loss, Subrogation...
We are adding to our Auto Claims Leadership Team! The Auto Property Damage Director is responsible for oversight... approvals over adjuster authority and the transfer of files to appropriate areas (SIU, Litigation, Total Loss, Subrogation...
special investigations unit (SIU) and FWA program. The Director oversees internal and external investigations into potential... communities and residents and to support the safety net required to achieve that purpose. Job Summary The Director, Compliance...
an independent, highly organized, and detail-oriented Executive Secretary to the Facility Director. This position will be responsible... in a timely manner. Essential Functions Serves as Secretary to the Facility Director. Keyboards and transcribes from oral...
a Strategic Growth Director to join our payer team and lead large-scale transformation sales cycles with national and regional...-year engagements) Bonus: Exposure to payment integrity, SIU/FWA, analytics, care management, or provider network...
of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation. Achieves... additional duties as assigned. Reporting Relationship Typically Director or above Skills, Knowledge & Abilities Thorough...
of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation. Achieves... additional duties as assigned. Reporting Relationship Typically Director or above Skills, Knowledge & Abilities Thorough...
, Special Investigations Unit (SIU), Clinical, Networks) and the PBM Program Integrity team to address identified claims payment... inaccuracies, quantify financial impact, and ensure timely submission of high-quality case leads to the SIU.. Independently...
and accurate determinations in compliance with CMS, NCQA, URAC and/or state guidelines. Interact with the Medical Director... requiring review by a PhD/PsyD. Serves as a subject-matter expert supporting SIU investigations. Collaborates with case...
operations. Triage and refer cases or inquiries to other BSC compliance resources (e.g., Privacy Office, SIU, Employee Relations... per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions: o Member-facing...
of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation. Achieves... additional duties as assigned. Reporting Relationship Typically Director or above Skills, Knowledge & Abilities Thorough...