North Carolina Licensed Special Investigator

Job Summary

A company is looking for a Special Investigator (Remote NC).

Key Responsibilities

• Conduct inquiries and investigations into complaints and allegations of healthcare fraud, waste, and abuse
• Review healthcare claims for compliance with rules and regulations, and prepare investigative summary reports
• Participate in appeal processes and provide litigation testimony as needed

Required Qualifications, Training, and Education

• Bachelor's degree in Healthcare compliance, fraud analytics, medical auditing, or related field
• Minimum of 3 years of experience in public agency, healthcare compliance, or fraud investigation
• Intermediate knowledge of local, state, and federal healthcare laws and regulations
• Preferred certifications include Qualified Professional, Accredited Healthcare Fraud Investigator, or Certified Fraud Examiner
• Residency in North Carolina or within 40 miles of the NC border is required