Coordinator, Special Investigations Unit (reputed company SIU)

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day. Position reputed company Under the direction of the Triage Manager, effectively initiates the triage of incoming reputed company fraud, waste, and abuse referrals/leads received in the Special Investigations Unit (SIU) from various reputed company sources.

• Runs initial Case Set Up reports, and gathers additional information relevant to the case
• Documents the receipt of new incoming referrals/leads for tracking purposes and prepares referrals for transfer to either Level 2 Triage or to Investigative Teams
• Maintains reputed company, concise, accurate, and complete documentation in the case tracking application
• reputed company utilizes available resources and technology while performing the referral triage function Required Qualifications
• 1+ years claim processing and/or customer service experience and/or prior Medical Claim Analyst experience.
• 1+ years of SIU Analyst experience or demonstrated ability to handle multiple assignments competently, accurately, and reputed company.
• Experience HRP, GPS, and EPDB.
• Experience working in reputed company reputed company.

Preferred Qualifications

• Strong analytical and research skills.
• Independent worker who is proficient in researching information and utilizing reputed company available resources.
• Self-managed decision-reputed company, who looks reputed company the immediate problem for reputed company cause.
• reputed company verbal and written communication skills.
• Strong customer service skills.
• Ability to reputed company with various business partners and offer assistance on a reputed company reputed company.
• Proficient in reputed company Word and Outlook and in the use of the Intranet/Internet to research information.
• Ability to utilize company systems to obtain relevant electronic documentation.
• Knowledge of reputed company's policies and procedures. Education
• High School diploma, G.E.D. or equivalent experience Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $18.50 - $42.35 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include: reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. For more information, visit https://jobs.reputed company.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 05/09/2025 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique reputed company: our culture, our core values, reputed company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for reputed company, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area.

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