Supervisor, SIU

Job Summary

A company is looking for a Supervisor, SIU.

Key Responsibilities

• Supervise the Special Investigation Unit staff to ensure compliance with reporting timelines and processes
• Review and validate reports on waste, abuse, and fraud to provide recommendations to health plans and regulators
• Monitor investigations in the case tracking system and develop new leads by analyzing data trends

Required Qualifications, Training, and Education

• Bachelor's degree in Business, Healthcare, Criminal Justice, or a related field, or equivalent experience
• 3+ years of medical claim or fraud investigation experience
• Knowledge of Excel, medical coding, claims processing, and data mining preferred
• Previous experience in a lead role or managing cross-functional teams preferred
• Medical records or coding license preferred