Healthcare Fraud Investigator 3072747 I.Html
Job Description
Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention, detection, investigation, and reporting of healthcare fraud, waste, and abuse while working remotely.
##### Key responsibilities
Develop leads and assess potential fraud, waste, or abuse corroborated by evidence
Conduct end-to-end investigations, including witness interviews, data analytics, and medical record reviews
Prepare detailed investigation referrals to regulatory agencies and ensure compliance with applicable regulations
##### Required qualifications
At least 2 years of investigative experience in the healthcare industry or equivalent education and experience
Proven investigatory skills with knowledge of fraud investigation procedures
Understanding of claim billing codes, medical terminology, and healthcare delivery systems
Ability to research and interpret regulatory requirements
Experience with data analytics to detect fraud, waste, and abuse
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