New York Licensed SIU Investigator

Job Summary

A company is looking for an SIU Investigator to investigate allegations of potential healthcare fraud and abuse activity.

Key Responsibilities

• Conduct investigations of potential waste, abuse, and fraud
• Document activity on each case and refer issues to the appropriate party
• Perform data mining and analysis to detect aberrancies and outliers in claims

Required Qualifications

• Associates or Bachelor's degree in criminal justice or a related field
• Minimum of five (5) years in healthcare field working in fraud, waste and abuse investigations and audits
• Five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies
• Seven years of professional investigation experience involving economic or insurance-related matters