Rgp
Role Overview
Our healthcare payer client urgently needs additional SIU support to handle a heavy caseload of fraud, waste, and abuse (FWA) investigations. The role is critical for maintaining compliance with state and federal regulations and ensuring claims integrity.
What You Will Do
Provide proactive detection, investigation, and reporting of FWA in compliance with state/federal regulations and in a fast-paced environment.
Why It Might Be a Fit
SIU investigations or Compliance background required, with ability to prioritize and move cases forward with a sense of urgency, strong investigative fundamentals, and healthcare fraud experience preferred.
Requirements
- Bachelor’s degree required
- Certified Fraud Examiner (CFE) certification or similar preferred
- Senior level experience with proactive and self-driven approach
- SIU investigations or Compliance background required
- Claims investigation experience required
Benefits
- Medical
- Dental
- Vision
- Life Insurance
- Disability Insurance
- 401(k) Savings Plan
- Employee Stock Purchase Plan
- Professional Development Program
- Paid Time Off
- Paid Sick Time
- Employee Stock Purchase Plan
Originally posted on Himalayas
To apply for this job please visit himalayas.app.
About this role & career path
Working in United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic consisting of 50 states and a federal capital district, Washington, D.C. The 48 contiguous states border Canada to the north and Mexico to the south, with the semi-exclave of Alaska in the northwest and the archipelago of Hawaii in the Pacific Ocean. The United States also asserts sovereignty over five major island territories and various uninhabited islands in Oceania and the Caribbean. It is a megadiverse country, with the world's th
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