Senior Investigator, Special Investigations

Devoted Com Inc

Base: $75,000 - $110,000 / year; bonus/equity: bon...
Fully remote
3 years health insurance fraud investigation experience
Medicare or medicaid program billing knowledge
Data mining and analysis for claims aberrancies
Devoted Com Inc is seeking a Senior Investigator for Special Investigations to oversee investigations related to healthcare fraud, waste, and abuse, primarily in Medicare and Medicaid. The ideal candidate will possess strong analytical skills, relevant experience in health insurance fraud investigation, and the ability to collaborate effectively with various stakeholders

Job Summary

  • The Senior Investigator plays a crucial role in investigating allegations of healthcare fraud, waste, and abuse to protect members and the Medicare Fund.
  • Responsibilities include performing data mining to detect anomalies in claims and medical records while serving as a subject matter expert for the SIU team.
  • The company offers a total rewards package including employer-sponsored health plans, stock options, bonus eligibility, and a $100 monthly mobile stipend.

Matching Summary

Match Score: 85

Devoted Com Inc is seeking a Senior Investigator for Special Investigations to oversee investigations related to healthcare fraud, waste, and abuse, primarily in Medicare and Medicaid. The ideal candidate will possess strong analytical skills, relevant experience in health insurance fraud investigation, and the ability to collaborate effectively with various stakeholders.

Salary

Base: $75,000 - $110,000 / year; Bonus/Equity: Bonus eligibility for all roles excluding Director and above; Stock options for all employees; Benefits: Employer sponsored health, dental, vision plan; Paid time off; $100 monthly mobile or internet stipend; Parental leave; 401K program

Skills & Requirements

Must-have

  • 3 years health insurance fraud investigation experience
  • Medicare or Medicaid program billing knowledge
  • Data mining and analysis for claims aberrancies
  • Experience with internal employee investigations
  • Knowledge of AI concepts for business processes

Nice-to-have

  • Strong analytical skills interpreting complex data sets
  • Excellent written and verbal communication skills
  • Detail-oriented commitment to integrity and compliance
  • Ability to work independently in fast-paced environment
  • Strong organizational skills managing multiple investigations

Key Requirements

  • Bachelor's Degree in Business, Criminal Justice, Healthcare, or related field
  • Certified Fraud Examiner (CFE) certification preferred
  • Certified Professional Coder (CPC) certification preferred

Work Rights

Not specified

Tailored Resume

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