Job Description
Title: SIU Clinical Healthcare Fraud Investigator III
Location:Remote
Position Type: Contract
Compensation
Pay Range:$45.00-$55.53 Per Hr
Description
Lead complex investigations into suspected healthcare fraud, waste, and abuse.
Independently manage investigations from intake through closure.
Develop strategies and prepare evidentiary packages for referrals.
Collaborate cross-functionally to safeguard organizational integrity.
Provide clinical and operational insight into billing patterns.
Act as a resource and mentor for other staff.
Key Responsibilities
Conduct complex clinical investigations involving misconduct.
Coordinate with law enforcement and regulatory agencies.
Analyze patterns and emerging schemes in healthcare fraud.
Prepare comprehensive reports and referral packets.
Mentor junior investigators and contribute to detection controls.
Qualifications
At least 4 years of coding experience.
At least 3 years conducting healthcare fraud investigations.
Expertise in clinical documentation review and regulatory compliance.
Strong understanding of coding and reimbursement structures.
Proven ability to mentor others and manage multiple investigations.
Contact Authorization:
By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy here https://www.mitchellmartin.com/privacy-policy.
Onboarding Expectations
Learn more about our Onboarding Process here https://youtu.be/rjV_NFYjyY4
EEO Statement
Learn more about our EEO policy here https://www.mitchellmartin.com/eoe-statement
Location:Remote
Position Type: Contract
Compensation
Pay Range:$45.00-$55.53 Per Hr
Description
Lead complex investigations into suspected healthcare fraud, waste, and abuse.
Independently manage investigations from intake through closure.
Develop strategies and prepare evidentiary packages for referrals.
Collaborate cross-functionally to safeguard organizational integrity.
Provide clinical and operational insight into billing patterns.
Act as a resource and mentor for other staff.
Key Responsibilities
Conduct complex clinical investigations involving misconduct.
Coordinate with law enforcement and regulatory agencies.
Analyze patterns and emerging schemes in healthcare fraud.
Prepare comprehensive reports and referral packets.
Mentor junior investigators and contribute to detection controls.
Qualifications
At least 4 years of coding experience.
At least 3 years conducting healthcare fraud investigations.
Expertise in clinical documentation review and regulatory compliance.
Strong understanding of coding and reimbursement structures.
Proven ability to mentor others and manage multiple investigations.
Contact Authorization:
By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy here https://www.mitchellmartin.com/privacy-policy.
Onboarding Expectations
Learn more about our Onboarding Process here https://youtu.be/rjV_NFYjyY4
EEO Statement
Learn more about our EEO policy here https://www.mitchellmartin.com/eoe-statement
Numbers & Facts
| Location | Los Angeles, CA (Remote) |
| Industry | Staffing/Employment Agencies |
| Salary | $45–$55.53 Per Hour |
| Company Size | 100 to 499 employees |
| Year Founded | 1984 |
| Website | https://www.mitchellmartin.com |
About Company
OUR FOCUS IS GROWTH
It’s not just about filling job openings. It’s about enabling growth and inspiring success. That’s what we do.
Mitchell Martin is one of the nation’s largest staffing companies, with offices throughout the US as well as in India and the Philippines. We help drive success for both people and companies by helping them achieve positive growth. We do this by building strong relationships and developing a deep understanding of the people we work with, in order to facilitate the best matches for both sides of the equation.
Skills
- Billingunmatched
- Clinical Study Publicationsunmatched
- Cross-Functionalunmatched
- Documentation Reviewunmatched
- Drug Developmentunmatched
- Fraud Investigationunmatched
- Healthcareunmatched
- Law Enforcementunmatched
- Mentoringunmatched
- Onboardingunmatched
- Pattern Analysisunmatched
- Regulationsunmatched
- Regulatory Complianceunmatched
- Reimbursementunmatched
- Reporting Skillsunmatched
- Strategic Planningunmatched
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