Healthcare Fraud Investigator Job at Virtual Vocations Inc, United States

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  • Virtual Vocations Inc
  • United States

Job Description

Seeking a full-time remote Healthcare Fraud Investigator, the successful candidate will manage complex investigations into healthcare fraud, waste, and abuse, utilizing data analysis techniques and serving as a subject matter expert while collaborating with various stakeholders. Key responsibilities Lead complex investigations into allegations of healthcare fraud, waste, and abuse Utilize advanced data mining and analysis techniques to identify anomalies in healthcare transactions Provide expert guidance and training to other SIU Investigators and contribute to policy development Required qualifications Bachelor's Degree in Business, Criminal Justice, Healthcare, or a related field, or equivalent experience Minimum of 3 years of experience in health insurance fraud investigation At least 5 years of experience as a detective or investigator for a law enforcement agency Proven experience with Medicare and/or Medicaid programs, including medical claim billing Demonstrated experience with data analysis techniques and AI tools

Job Tags

Full time, Remote work

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