Special Investigations Unit Investigator

Job Summary

A company is looking for a Special Investigations Unit Investigator to work remotely.

Key Responsibilities

• Conduct investigations into fraud, waste, and abuse cases, including outreach and data analysis
• Perform risk assessments on FWA trends and assist with the Medicaid Recipient Restriction program
• Document investigative activities and maintain case updates in an internal database

Required Qualifications

• Bachelor's Degree preferred or 2-4 years of relevant experience in investigations, claims, or data analysis
• Experience in conducting investigations within a healthcare environment preferred
• Knowledge of CPT and ICD-10 coding is preferred
• Familiarity with medical terminology and anatomy is preferred
• Proficiency in MS Office, particularly Excel and Word