Healthcare Fraud Investigator

Healthcare Fraud Investigator / SIU – Hybrid!

HealthCare Support is actively seeking a Healthcare Fraud Investigator II / SIU to join a respected health plan organization, that provides Medicare and Medi-Cal healthcare services to over 1.5 million members in Rancho Cucamonga, California.

Schedule:

• Monday – Thursday 8:00 am – 5:00 pm
• Onsite Tuesday – Thursday and remote on Mondays and Fridays

Compensation:

• $80,000 – $105,000 annually (depending on experience)
• Annual HEDIS Incentive: Up to 10%
• Annual Merit Increases: Up to 3% based upon individual performance

Benefits:

• Exceptionally Low Premiums: Medical coverage starting as low as $35/month plus $5/month dental and free vision coverage Affordable Family Coverage: Add a spouse or dependents for as little as $72–$90/month on medical and $10/month for family dental
• Exceptional Retirement Benefits: CalPERS Pension Plan + 457(b) Retirement Plan with a 3% employer match
• 3 ½ weeks of PTO (18 days) & 11 Paid Holidays
• Fitness Reimbursement up to $125/a year and on-site fitness facility
• Tuition reimbursement after 1 year of employment

Daily Responsibilities:

• Conducting full investigations to proactively prevent, detect, and correct suspected and identified issues of fraud, waste, and abuse (FWA), including reporting to State and/or Federal regulatory agencies, such as set forth by the CMS, HHS-OIG, DMHC, and DHCS.

Qualifications:

• Bachelor’s degree from an accredited institution In lieu of the required degree, a minimum of 4 years of additional relevant work experience is required for this position (8-years)
• 4+ years relevant professional experience in fraud, waste, and abuse investigations, including Federal and State reporting requirements
• Experience in health care fraud investigation, detection, and/or healthcare related specialty including but limited to; Pharmacy, DEM, Mental Health, Behavioral Health, Hospice, Home Health, claims, or claims processing

Interested in this opportunity?

Click Apply Now for immediate consideration, or reach out to our Recruiter, Melanie Williams with any questions:

• Call: (407) 346-0844
• Email:
• Schedule a Call:

Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

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