Telecommute Senior Investigator in Nashville

Job is Expired

Location: Tennessee

Compensation: To Be Discussed

Staff Reviewed: Wed, Jul 07, 2021

Job Category: Investigations

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Job Summary

A global healthcare company is searching for a person to fill their position for a Telecommute Senior Investigator in Nashville.

Core Responsibilities of this position include:

  • Gathering and analyzing data and information gathered to determine behavior and understand provider/scheme at issue
  • Collaborating with clinical coding consultant to apply knowledge of coding guidelines to determine validity of aberrances (SIU only)
  • Collaborating with a variety of external sources to identify current and emerging patterns and schemes

Must meet the following requirements for consideration:

  • Associate's Degree in the area of Criminal Justice or experience in a related field (or 5+ years of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location)
  • 2+ years of experience within the health insurance claims industry
  • 2+ years of experience working with law enforcement or legal entities or 3-5 years Investigative experience with fraud investigations
  • 1+ years knowledge and/or experience with behavioral health codes and service delivery

COMPLETE JOB DESCRIPTION

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