Florida Licensed SIU Manager
Job Summary
To develop and manage strategic fraud, waste, and abuse activities, the full-time Florida Licensed SIU Manager will monitor compliance in billing and claims payment, lead investigations into referrals, and create educational materials, all while working remotely.
Key responsibilities
- Monitor business processes and systems to ensure integrity and compliance in billing and claims payment
- Lead a team to investigate all potential fraud, waste, and abuse referrals
- Prepare and distribute monthly and quarterly savings reports
Required qualifications
- Bachelor's degree in Business, Healthcare, Criminal Justice, or a related field, or equivalent experience
- 4+ years of experience in medical claim investigation, financial impact analysis, or compliance related to fraud and abuse
- Thorough knowledge of medical terminology
- Preferred experience in a managed care environment and supervisory roles
- Knowledge of Microsoft Excel, medical coding, and claims processing is preferred
Complete Job Description
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