Texas Licensed SIU Investigator

Job Summary

Investigating allegations of potential healthcare fraud and abuse, the full-time Texas Licensed SIU Investigator will conduct claims investigations, perform data analysis, and prepare reports while working remotely.

Key responsibilities

• Conduct investigations of potential waste, abuse, and fraud in healthcare claims
• Document case activities and refer issues to the appropriate parties
• Prepare detailed reports on investigative findings for referral to Federal and State agencies

Required qualifications

• Bachelor's Degree in Business, Criminal Justice, Healthcare, or related field, or equivalent experience
• Minimum of 1 year of experience in medical claim investigation, audit, analysis, or fraud investigation
• Experience in data mining and analysis to detect anomalies in claims
• Ability to develop queries and reports to identify potential fraud
• Familiarity with compliance policies and standards in healthcare investigations