Certified Fraud Investigator Team Lead

Job Summary

Driving innovative investigative processes, the full-time salaried Certified Fraud Investigator Team Lead will manage the day-to-day activities of investigative staff, assign cases, and monitor investigation allocations while working remotely.

Key responsibilities

• Direct the daily operations and leadership of investigative teams to meet departmental goals
• Identify training opportunities and mentor staff to enhance their ability to recognize fraud and abuse indicators
• Collaborate with cross-functional teams to develop and implement departmental standard operating procedures and performance metrics

Required qualifications

• Bachelor's degree in a health-related field, law enforcement, or insurance; Master's degree preferred
• Five years of experience in healthcare fraud investigations, medical coding, or related fields
• One of the following certifications: Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE) required
• Supervisory or leadership experience preferred
• Knowledge of government program compliance requirements, such as Medicare and Medicaid