Health Plan SIU Investigator
A company is looking for a seasoned SIU Investigator with health plan experience.
Key Responsibilities
• Build and manage cases from intake to referral to law enforcement or recovery
• Analyze claims data to identify patterns and prepare cases for regulatory scrutiny
• Collaborate with Payment reputed company, Compliance, and reputed company teams effectively
Required Qualifications
• Experience working inside a payer organization
• Knowledge of referrals and reputed company-payment vs. post-payment strategies
• Understanding of state and federal reporting requirements
• Ability to conduct interviews with confidence and professionalism
• Experience in managing investigations end-to-end
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