SIU Investigator III
$43 per hourTemporary
Kforce has a client that is seeking a SIU Investigator III in Los Angeles, CA. This is a remote position (must live within driving distance from office). The duration is 3 months (CTH). Once you convert to FTE - once a month, onsite is required. Overview: The Special Investigation Unit Investigator III performs in-depth evaluation of potential fraud and abuse cases and develops complex investigations that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for fraud, waste, and abuse. In addition, this position is responsible for building the investigative approach and providing leadership for Investigators through mentoring, on-site audit leadership, and hands-on training of investigative techniques. * 5+ years of healthcare fraud, waste, and abuse (FWA) investigations Healthcare fraud investigation experience within:
- Pharmacy
- DME (Durable Medical Equipment)
- Mental Health/Behavioral Health
- Hospice
- Home Health
- Dental
- Experience conducting investigations and fact-finding interviews
- Experience analyzing claims data and detecting unusual billing patterns
- Pivot Tables
- Complex formulas/calculations
- Comparing large datasets
- Experience writing investigative reports and documenting findings
- Knowledge of Medicare and/or Medi-Cal fraud investigations
- Ability to support conclusions with documented evidence
Vacancy posted 4 days ago
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