Kentucky Licensed Senior SIU Investigator

A company is looking for a Senior SIU Investigator to investigate allegations of healthcare fraud and abuse activity.

Key Responsibilities

Investigate possible waste, abuse, and fraud leads and document activity

Perform data mining and analysis to detect aberrancies and outliers in claims

Prepare summary and detailed reports on investigative findings for referral to Federal and State agencies

Required Qualifications

Bachelor's Degree in Business, Criminal Justice, Healthcare, or a related field, or equivalent experience

3+ years of experience in medical claim investigation, audit, analysis, or fraud investigation

Knowledge of Microsoft Applications, medical coding, claims processing, and data mining preferred

Certified Professional Coder certification preferred