SIU Post Pay Investigator

Job is Expired
Location: Nationwide
Compensation: Salary
Staff Reviewed: Mon, Sep 25, 2023

Job Summary

A company is looking for a SIU Post Pay Investigator.

Key Responsibilities:
  • Gather and analyze data to determine behavior and understand provider/scheme at issue
  • Collaborate with external sources to identify patterns and schemes related to Fraud, Waste, Abuse, and Error (FWAE)
  • Conduct confidential investigations, document findings, and communicate outcomes to stakeholders
Required Qualifications:
  • Associate's Degree in Criminal Justice OR residence in the state of New York or New Jersey AND 5+ years of experience in FWA/SIU or Fraud investigations
  • 2+ years of experience in health insurance claims industry
  • 2+ years of experience working with law enforcement or legal entities OR 3+ years of investigative experience with fraud investigations
  • 1+ years of knowledge and/or experience with behavioral health codes and service delivery
  • Intermediate level proficiency in Microsoft Excel (pivot tables and macros) and Word (documents)

COMPLETE JOB DESCRIPTION

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