Fraud Investigations Analyst

Job Summary

Conducting thorough health care fraud investigations, the full-time Senior Fraud Investigations Analyst will manage cases from inception to closure, ensuring compliance with regulations and providing presentations on fraud awareness, all while working remotely across various states.

Key responsibilities

• Conducts investigations in accordance with the investigative action plan and documents findings per SIU Policies and Procedures
• Identifies errors and control deficiencies, communicating their impact on the organization
• Prepares presentations and provides content for health care fraud and abuse education and awareness

Required qualifications

• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in a related field, or 7+ years in lieu of a degree
• Working knowledge of Medicare programs and reimbursement principles
• Professional certifications such as AHFI or CFE are a plus
• Strong Excel skills for organizing and tracking case data