Healthcare Fraud Investigator

Job Summary

A company is looking for a SIU Investigator to conduct healthcare fraud investigations.

Key Responsibilities

• Analyze billing and coding patterns to identify abnormal practices
• Conduct data mining activities using analytical tools and databases
• Prepare and submit comprehensive investigative reports and document findings

Required Qualifications

• Bachelor's degree with 2+ years of healthcare fraud investigations experience, or
• Associate degree with 5+ years of healthcare fraud investigations experience, or
• High school equivalency with 8+ years of healthcare fraud investigation experience
• Strong knowledge of health insurance, billing/coding terminology, and regulations
• Advanced proficiency with Microsoft Office applications