Healthcare Fraud Investigator
New
Miami, FL / Remote / Hybrid / Tampa, FLFull-TimeMiddle
Salary85,000 - 105,000 USD per year
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Job Details
- Experience
- Minimum three (3) years
- Required Skills
- Data AnalysisMicrosoft ExcelMicrosoft Office
Requirements
- Four-year undergraduate degree or higher in criminal justice, finance, project management, or a related field.
- Minimum three years of professional work experience in healthcare, fraud, or a related investigative field.
- Proficiency in Microsoft Office applications including Outlook, Word, Excel, and PowerPoint.
- Proficiency in analyzing data to provide specific case support in civil HCF matters, such as Medicare, Medicaid, or outlier data.
- Ability to interact professionally and effectively with diverse stakeholders including AUSAs, court personnel, and witnesses.
- Must be able to obtain a favorably adjudicated Public Trust Clearance.
Responsibilities
- Review, sort, and analyze data using computer software programs such as Microsoft Excel.
- Review financial records, complex legal and regulatory documents and summarize contents.
- Prepare spreadsheets of financial transactions, such as check spreads.
- Develop Healthcare Fraud (HCF) case referrals and ensure they meet agency and USAO standards.
- Analyze data for evidence of fraud, waste, and abuse.
- Evaluate referrals to determine the need for additional information and evidence.
- Advise HCF attorneys on the merits and weaknesses of referrals based on applicable law and evidence.
- Assist in conducting witness interviews and preparing written summaries.
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