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Senior Fraud Investigations Analyst

AnalystAnalystFull TimeRemoteSeniorTeam 501-1,000Since 1997H1B No SponsorCompany SiteLinkedIn

Location

Kentucky + 4 moreAll locations: Kentucky | North Carolina | South Carolina | Wisconsin | Wyoming

Posted

49 days ago

Salary

$81.1K - $129.7K / year

Seniority

Senior

Bachelor Degree5 yrs expExperience acceptedEnglish

Job Description

Senior Fraud Investigations Analyst

E-Verify Program

• Conducts investigations in accordance with investigative action plan and documents all findings in standard with SIU Policies and Procedures • Identifies errors and control deficiencies. • May be required to provide deposition and/or testimony • Conduct interviews of victims, subjects and/or other related persons • Prepares and conducts presentations and/or provides content for health care fraud and abuse education and awareness.

Job Requirements

  • Bachelor's degree or advanced degree (where required)
  • 5+ years of experience in related field.
  • In lieu of degree, 7+ years of experience in related field.
  • Working knowledge of Medicare programs and reimbursement principles, including general billing requirements and documentation expectations
  • Professional certifications such as AHFI (Accredited Healthcare Fraud Investigator), CFE (Certified Fraud Examiner), or similar healthcare fraud or compliance credentials
  • Experience reviewing and vetting investigative leads and determining appropriate next steps
  • Strong Excel skills for organizing, tracking, and reviewing case data (e.g., filtering, sorting, basic formulas, pivot tables)

Benefits

  • Medical, dental, and vision coverage along with numerous health and wellness programs.
  • Parental leave and support plus adoption and surrogacy assistance.
  • Career development programs and tuition reimbursement for continued education.
  • 401k match including an annual company contribution

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