Healthcare Fraud Investigator

Job Summary

A company is looking for a Healthcare Fraud Investigator II.

Key Responsibilities

• Conducts audits/investigations into customer claims, ensuring accurate assessments of claims validity
• Compiles detailed records of audit/investigation findings, ensuring compliance with legal and regulatory requirements
• Communicates audit/investigation findings clearly to stakeholders and assists in training other auditors/investigators

Required Qualifications

• Minimum Bachelor's Degree
• Certified Fraud Examiner or Accredited Healthcare Anti-fraud Investigator preferred
• Minimum of 2-4 years of relevant experience
• 5-7 years of experience preferred