Healthcare Fraud Investigator

Job Summary

A company is looking for a SIU Investigator to uncover healthcare fraud, waste, and abuse through meticulous investigation and data analysis.

Key Responsibilities

• Lead complex investigations into healthcare fraud, waste, and abuse allegations
• Utilize data mining techniques to identify anomalies in healthcare transactions
• Provide expert guidance and training to other SIU Investigators

Required Qualifications

• Bachelor's Degree in Business, Criminal Justice, Healthcare, or related field, or equivalent experience
• Minimum of 3 years in health insurance fraud investigation
• At least 5 years as a detective or investigator for a law enforcement agency
• Proven experience with Medicare and/or Medicaid programs
• Demonstrated experience with data analysis techniques