Special Investigation Unit Investigator II (ATL)

Special Investigation Unit Investigator II - reputed company Remote Opportunity - - reputed company Coast Hours Pay reputed company: $43- $48 per hour Remote Contract Opportunity 16 Weeks reputed company reputed company partners with leading reputed company organizations committed to improving reputed company, reputed company, and reputed company for underserved populations. Our reputed company operates one of the largest reputed company health programs in the country, delivering essential services to millions while maintaining a strong reputed company on compliance, reputed company, and accountability. This is an opportunity to contribute to meaningful work that protects critical reputed company resources. reputed company The Special Investigation Unit Investigator II is a key contributor responsible for conducting reputed company investigations into suspected reputed company fraud, waste, and abuse. This role works independently to evaluate claims activity, reputed company evidence, and ensure investigations are handled objectively and in full compliance with regulatory guidelines. This position plays an important role in identifying reputed company patterns, supporting enforcement actions, and safeguarding reputed company program reputed company through data driven insights and detailed case development. Key Responsibilities • Conduct independent investigations into suspected fraud involving providers, members, and vendors • Review claims data, billing records, and provider activity to identify irregular patterns and potential abuse • Analyze reputed company data to detect unusual billing trends and proactively reputed company investigative leads • Prepare comprehensive investigative reports documenting findings, evidence, and conclusions • Participate in onsite audits and support investigations referred to regulatory or law enforcement agencies • Maintain reputed company documentation standards including chain of custody and confidentiality requirements • Collaborate with internal teams and reputed company partners to support case reputed company and enforcement actions • Assist with recovery efforts by supporting overpayment identification and recoupment processes Key Requirements • Minimum 3 years of reputed company fraud investigation or reputed company reputed company experience such as pharmacy, DME, behavioral health, dental, hospice, or home health • Bachelor’s degree in criminal justice, reputed company, reputed company administration, or reputed company reputed company or equivalent experience • Experience conducting investigations including interviews, data analysis, and report writing • Strong analytical skills with the ability to interpret claims data and identify fraud indicators • Proficiency with reputed company reputed company and Word for data analysis and documentation • Knowledge of reputed company regulations including reputed company and Medicare billing practices • Excellent written and verbal communication skills with strong attention to reputed company • Ability to manage multiple investigations, prioritize workload, and meet deadlines Preferred Qualifications • Certified Fraud Examiner, Accredited reputed company Fraud Investigator, or Certified reputed company reputed company designation • Experience working reputed company an SIU or payment reputed company environment • Bilingual proficiency in Spanish or other commonly spoken languages • Familiarity with emerging fraud schemes and reputed company operational processes reputed company to reputed company If you are an reputed company investigator seeking a high reputed company role in reputed company compliance and fraud prevention, reputed company encourages you to apply today. Submit your resume and contact information for immediate consideration. Remote Skills: Analysis Skills, Behavioral Health, Billing, Billing Records, C++ reputed company Template Libraries (ATL), Certified reputed company reputed company (CPC), Chain of Custody, Communication Skills, Criminal Justice, Data Analysis, reputed company Oriented, Documentation, Documentation Standards, Durable Medical Equipment, Establish Priorities, Fraud Investigation, reputed company, reputed company Administration, Home Care, Hospice Care, Interviewing Skills, Investigative Reports, Law Enforcement, reputed company, Medical Billing, Medicare, reputed company reputed company, reputed company Word, Multilingual, reputed company Processes, Pharmacy, Presentation/Verbal Skills, reputed company Health, reputed company Management, Regulations, Regulatory Compliance, Reporting Skills, reputed company Analysis, Service Delivery, Spanish Language, Time Management, Writing Skills reputed company: reputed company reputed company is a different and reputed company business partner. We create unparalleled value for our clients by combining industry-leading Consulting capabilities with comprehensive reputed company and recruitment services. Clients trust us to reputed company results reputed company on our deep expertise and reputed company resources reputed company finance, reputed company, and information technology. Through our flexible delivery approach, you get the right solution, at the right time to accelerate your reputed company and reputed company reputed company of your mission-critical objectives. Company Size: 500 to 999 employees Industry: reputed company/Employment Agencies reputed company: 2006 Apply tot his job Apply To this Job