Telecommute Senior Investigator in Eden Prairie

Job ID: Available for Members

Location: Minnesota

Compensation: To Be Discussed

Staff Reviewed: Fri, Feb 09, 2018

Job Category: Investigations

Telecommute Level: 100% Telecommute

Travel Requirements: No Travel

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Job Summary

A healthcare company needs applicants for an opening for a Telecommute Senior Investigator in Eden Prairie.

Core Responsibilities Include:

  • Conducting confidential investigations, document relevant findings and report any illegal activities in accordance with all laws and regulations
  • Reviewing claims, looking for patterns of potential fraud, waste and / or abuse and interacting with medical providers to request medical records for investigations
  • Conducting onsite provider claim and / or clinical audits

Must meet the following requirements for consideration:

  • High school diploma
  • 3 years of experience working in a government, legal, law enforcement, investigations, healthcare, managed care and / or health insurance environment
  • 3 years of experience in a position processing medical claims and / or investigating fraud
  • Experience communicating complex information via phone conversations and emails to non - technical clients