SIU Investigator (45)

Summary

To support healthcare fraud investigations, the full-time Minnesota Licensed SIU Investigator will conduct thorough investigations, analyze trends, and provide mentorship to investigative teams while working remotely.Key responsibilities:Perform root-cause and trend analysis to develop prevention strategies and recommendationsGather facts and create comprehensive Investigation Summaries and compliance packagesProvide case direction and mentorship to investigators, ensuring adherence to documentation standardsRequired qualifications:High School Diploma / GEDCertified Professional Coder (CPC) or RHIT certificationProfessional certification as a Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI)5+ years of experience in fraud investigations or FWA/SIU roles2+ years of experience in the health insurance claims industry

Job Description

To support healthcare fraud investigations, the full-time Minnesota Licensed SIU Investigator will conduct thorough investigations, analyze trends, and provide mentorship to investigative teams while working remotely.Key responsibilities:Perform root-cause and trend analysis to develop prevention strategies and recommendationsGather facts and create comprehensive Investigation Summaries and compliance packagesProvide case direction and mentorship to investigators, ensuring adherence to documentation standardsRequired qualifications:High School Diploma / GEDCertified Professional Coder (CPC) or RHIT certificationProfessional certification as a Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI)5+ years of experience in fraud investigations or FWA/SIU roles2+ years of experience in the health insurance claims industry