Fraud Investigator

Job Summary

A company is looking for an Investigator for the Specialist Investigations Unit.

Key Responsibilities

• Perform target claim audits and distribute audit reports as required
• Conduct investigations including data analysis and provider office inspections
• Communicate audit findings to the Special Investigations Unit and relevant regulatory entities

Required Qualifications and Education

• Bachelor's degree preferred
• 1-2 years of experience in FWA investigating in a healthcare operation
• Knowledge of corporate investigative practices and medical terminology
• Leadership skills to effectively communicate with staff and regulatory representatives
• Preferred 3-5 years of experience in FWA investigating in a healthcare operation