Senior Fraud Investigator
virtual vocationsDenver, CO
Senior Fraud Investigator
L5
virtual vocationsDenver, COtoday
Occupations
Fraud Examiners, Investigators and AnalystsFinancial Risk SpecialistsDetectives and Criminal InvestigatorsIndustries
Investigation and Personal Background Check ServicesFinancial Transactions Processing, Reserve, and Clearinghouse ActivitiesOther Activities Related to Credit IntermediationIndependently leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator will utilize advanced investigative techniques and data analysis to identify misconduct and support corrective actions in a remote work environment.
Key responsibilities:
Conducts thorough investigations involving providers, members, and vendors using various data sources and analytical methods
Prepares comprehensive reports and documentation for leadership, regulatory agencies, and law enforcement
Collaborates with stakeholders to support investigative activities and recommend enhancements to processes and monitoring activities
Required qualifications:
Bachelor's Degree in Business, Criminal Justice, Healthcare Administration, Public Health, or a related field; Master's Degree preferred
4+ years of experience in fraud, waste, and abuse investigations or related investigative work
Experience leading complex investigations and preparing detailed reports for various stakeholders
Knowledge of federal and state healthcare regulations, including Medicaid and Medicare
Preferred certifications include Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE)
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Level
SeniorL5
Location
Denver, CO
Occupation
Fraud Examiners, Investigators and Analysts
Industry
Investigation and Personal Background Check Services
Posted
today
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