Junior Healthcare Fraud Investigator
United StatesFull-TimeJunior
Salary not disclosed
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Job Details
- Languages
- Spanish, English
- Experience
- 1+ years
- Required Skills
- Data AnalysisMicrosoft AccessMicrosoft Excel
Requirements
- Bilingual Spanish and ability to pass oral and written assessments
- A bachelor’s degree in a Criminal Justice, or related field
- 1+ years professional work experience, preferably with health insurance investigations/audit
- Outstanding technical & analytical skills, with particular proficiency with Access, Excel and Word
- Excellent verbal and written communication skills, along with ability to effectively manage conflict
- Keen ability to deal with ambiguity and leverage reasoning skills
- Possession of a strong desire and demonstrated ability to lead
Responsibilities
- Analyze information gathered by investigation/audit and report findings and prepare written summary/recommendations
- Prepare evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies
- Support 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
- Represent company as a witness in judicial proceedings when appropriate
- Prepare reports to expedite tracking and reporting of investigations
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