Junior Investigator, Program Integrity
Job Summary
To support the Program Integrity Unit, the full-time Junior Investigator will perform investigative research, analyze data for potential fraud indicators, and document findings while working remotely.
Key responsibilities
- Conduct preliminary research and assist in investigations related to fraud, waste, and abuse
- Analyze claims data to identify patterns and anomalies that may require further investigation
- Document investigative activities and maintain accurate records within the case management system
Required qualifications
- 1 to 3 years of experience in healthcare operations, claims analysis, or related fields
- Bachelor's degree in criminal justice, Healthcare Administration, or a related field, or equivalent experience
- Basic understanding of healthcare fraud, waste, and abuse concepts
- Experience with healthcare claims processing or investigative support
- Proficiency with Microsoft Office applications, especially Excel
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