Fraud Investigation Specialist

Job Summary

A company is looking for a SIU Investigator to investigate allegations of potential healthcare fraud and abuse.

Key Responsibilities

• Conduct investigations of potential waste, abuse, and fraud
• Document activity on each case and refer issues to the appropriate party
• Perform data mining and analysis to detect aberrancies and outliers in claims

Required Qualifications

• Bachelor's Degree in Business, Criminal Justice, Healthcare, or related field, or equivalent experience required
• 1+ years of experience in medical/pharmacy claim investigation, audit, analysis, or fraud investigation required