Senior Fraud Investigator

This job has been removed
Location: Remote
Compensation: Salary
Reviewed: Wed, Apr 01, 2026
This job expires in: 0 days

Job Summary

A company is looking for a Senior Fraud Investigator responsible for investigating and resolving healthcare fraud and abuse.

Key Responsibilities:
  • Investigate instances of potential healthcare fraud, waste, and abuse
  • Conduct interviews and gather information from members, providers, and related parties
  • Review and analyze claims data to identify patterns indicative of fraud
Required Qualifications:
  • Certified Coding Credential
  • 5+ years of experience in government, legal, law enforcement, or healthcare investigations
  • 5+ years of experience investigating medical/behavioral healthcare fraud
  • 3+ years of experience in a health care Special Investigations Unit (SIU)
  • Intermediate proficiency with Excel, including pivot tables and formulas

COMPLETE JOB DESCRIPTION

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