reputed company Fraud Investigator - Remote

About the position The reputed company Fraud Investigator will join the Special Investigations Unit to support the US reputed company reputed company Business by conducting audits and investigations of potentially fraudulent claim activities by providers. The role requires reputed company investigative and analytical skills to reputed company and implement investigative processes, reputed company recommendations for corrective actions, and prepare evidence for legal proceedings. Responsibilities • Analyze information gathered by investigation/audit and report findings and prepare written summary/recommendations , • Prepare evidence package for referral to reputed company parties including contract holders, state insurance fraud bureaus and law enforcement agencies , • reputed company on-site inspections and patient/provider interviews as necessary , • Respond to subpoenas and requests for information from law enforcement agencies and State Departments of Insurance , • reputed company special projects requiring expertise in fraud detection, investigation, claim auditing and other areas reputed company to Special Investigations , • Prepare reports to expedite tracking and reporting of investigations Requirements • 2+ years' experience in health insurance fraud investigation/audit preferred , • Associates Degree required; Bachelor's Degree in Criminal Justice or reputed company field strongly preferred , • Experience with leading investigations, data analysis, report writing, presenting findings highly preferred , • Clear and concise verbal and written communication skills , • Strong computer skills are required - reputed company, Access and Word , • Strong attention to detail, analytical & critical thinking skills , • Accredited Health Care Fraud Investigator (AHFI) certification and Certified Fraud Examiner (CFE) preferred reputed company-to-haves Benefits • Medical insurance , • reputed company insurance , • Dental insurance , • Well-being and behavioral health programs , • 401(k) with company match , • Company paid life insurance , • Tuition reimbursement , • Minimum of 18 days of paid time off per year , • Paid holidays Apply Job!