Louisiana Licensed SIU Manager
Job Summary
To manage strategic fraud, waste, and abuse activities, the full-time Louisiana Licensed SIU Manager will develop and implement compliance measures, lead investigations into fraud referrals, and create educational materials, all while working remotely.
Key responsibilities
- Monitor business processes and systems to ensure integrity and compliance in billing and claims payment
- Lead a team to investigate all possible fraud, waste, and abuse referrals
- Prepare and distribute monthly and quarterly savings reports
Required qualifications
- Bachelor's degree in Business, Healthcare, Criminal Justice, or a related field, or equivalent experience
- 4+ years of experience in medical claim investigation, financial impact analysis, or compliance related to fraud and abuse
- Thorough knowledge of medical terminology
- Previous experience in a managed care environment and as a lead or supervisor preferred
- Knowledge of Microsoft Excel, medical coding, claims processing, and data mining preferred
Complete Job Description
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