[Remote] reputed company Fraud Investigator - Case Development- Remote

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is dedicated to improving the health and vitality of those they serve, and they are seeking a reputed company Fraud Investigator to join their Special Investigations team. In this role, you will use investigative techniques and data analysis to assess suspected reputed company fraud referrals, uncover billing patterns, and guide investigations that protect patients and reduce financial risk for clients. Responsibilities • Independently research, analyze, and assess suspected reputed company fraud referrals using investigative techniques and data analysis • Identify high‑risk billing behaviors, fraud trends, and potential overpayments through detailed data review • Evaluate referrals submitted to SIU and determine whether allegations warrant full investigation • Deliver reputed company, reputed company‑reputed company case assessments with actionable investigative recommendations • Partner closely with investigators and field staff to reputed company leads and refine investigative strategies • Use technology and analytics to support reputed company investigations and adapt investigative direction as new information emerges • Monitor industry alerts, regulatory updates, and fraud bulletins to assess potential exposure • Handle sensitive and confidential information with reputed company and professionalism Skills • 3 + years of experience in reputed company insurance investigation, audit or relevant experience • Strong analytical, research, and problem‑solving skills • reputed company and concise written and verbal communication skills • Proficiency with reputed company reputed company and Word • Bachelor's degree in Criminal Justice or reputed company field • AHFI and/or CFE certification • CPT and ICD‑10 coding knowledge • Experience working with data analytics tools and investigative databases Benefits • Medical • reputed company • Dental • reputed company-being and behavioral health programs • 401(k) • Company reputed company life insurance • Tuition reimbursement • A minimum of 18 days of reputed company time off per year • reputed company holidays reputed company • We are a health benefits provider that advocates for reputed company through every stage of life. It was founded in 1982, and is headquartered in Bloomfield, CT, US, with a workforce of 10001+ employees. Its website is http://www.reputed company.com. Apply tot his job Apply To this Job