The Special Investigations Unit is responsible for investigating and resolving high complexity healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. This position researches, gathers, and analyzes claims data, medical records, corporate policy, state/federal policy, and practice standards to identify trends, patterns, aberrancies, and o

The Claims Supervisor will play a crucial role in ensuring the efficient and accurate processing of healthcare claims within our organization. You will lead a team of claims analysts, oversee claim submission, review, and adjudication processes, and collaborate with various stakeholders to maintain high quality claims management practices. This role demands strong leaders

Do you enjoy helping others? Can you see yourself being the face of State Farm helping our customers in their time of need? This position is for a Fire Team Manager, overseeing Claim Specialists who handle one or a combination of the following accidental and weather related homeowners, commercial, and large loss claims. Team Managers are committed to leading and developin

Under the direction of the Manager of Operations, the Appeals Specialist is responsible for ensuring the appropriate review, research, processing and responding to written member and provider complaints, appeals, and grievances. This position is required to apply analytical and critical thinking when reviewing contract language, benefits and covered services in researchin