Fraud Investigator-Healthcare

Job Overview We are seeking a detail-oriented and analytical Fraud Investigator to join our team. The ideal candidate will be responsible for investigating and analyzing potential fraudulent activities, ensuring compliance with laws and regulations, and implementing effective fraud prevention measures. This role requires a strong understanding of data collection, report writing, and the ability to work in a dynamic and changing environment and mitigate risks associated with fraud. Duties - Conduct thorough investigations into suspected fraudulent activities by gathering evidence through data collection, record reviews, and interviews. - Prepare detailed reports documenting findings, methodologies, and recommendations for action. - Collaborate with law enforcement agencies as necessary to support investigations and prosecutions. - Analyze trends in fraudulent activities to develop proactive fraud prevention strategies. - Maintain accurate records of investigations and ensure compliance with relevant laws and regulations. - Provide training and guidance to staff on fraud detection techniques and best practices. - Stay updated on industry trends, emerging fraud schemes, and regulatory changes impacting fraud investigation. Requirements - Proven experience in healthcare fraud investigation (minimum 3 years). - Strong skills in data collection, report writing, and research methodologies. - - Previous experience working in a healthcare FWA SIU environment - Excellent analytical skills with the ability to think critically and solve complex problems. - Strong attention to detail and the ability to work independently as well as part of a team. - Effective communication skills, both written and verbal, are necessary for presenting findings clearly. -Candidate must be an Ohio resident for this role. If you do not reside in Ohio, please do not submit your application. If you do not have the minimum experience as noted above, please do not submit your application, as our requirements are specific for the role. Surveillance investigators, AML/banking investigators, correctional officers and law enforcement professionals with no prior healthcare FWA experience, will not be considered due to the specific requirements for the role. Join our team as a Fraud Investigator where your expertise will play a crucial role in safeguarding our organization against fraudulent activities while contributing to a culture of integrity and accountability. Job Type: Full-time Benefits:

• 401(k)
• Dental insurance
• Vision insurance

Application Question(s):

• Do you have prior healthcare FWA experience?
• Do you reside in the State of Ohio

Work Location: Remote Apply To This Job