Job Details

A company is looking for an SIU Investigator to investigate allegations of potential healthcare fraud and abuse activity.Key ResponsibilitiesConduct investigations of potential waste, abuse, and fraudDocument activity on each case and refer issues to the appropriate partyPerform data mining and analysis to detect aberrancies and outliers in claimsRequired QualificationsAssociates or Bachelor's degree in criminal justice or a related fieldMinimum of five (5) years in healthcare field working in fraud, waste and abuse investigations and auditsFive years of insurance claims investigation experience or professional investigation experience with law enforcement agenciesSeven years of professional investigation experience involving economic or insurance-related matters