Job Description
Title: Special Investigation Unit Investigator III
Location:Remote
Position Type: Contract
Compensation
Pay Range:$42.71-$55.53 Per Hr
Description
Join our team as a Special Investigation Unit Investigator III in a remote, contract position.
You will conduct detailed evaluations of potential fraud and abuse cases, leading complex investigations.
The role requires strong analytical skills and expertise in investigative techniques, utilizing various data analysis tools.
Perform in-depth evaluations of potential fraud and abuse cases involving high dollar amounts.
Develop and lead complex investigations, providing mentorship and training to junior investigators.
Ensure adherence to policies and procedures across all product offerings.
Conduct investigation-related training and serve as a subject matter expert.
Compile and maintain comprehensive documentation and reporting requirements.
Participate in hearings and appeals, and testify as a witness in court proceedings.
Develop and maintain strong working relationships with regulatory bodies and law enforcement.
Key Responsibilities
Investigate allegations of healthcare fraud by providers or members.
Analyze data to detect unusual billing patterns and initiate appropriate actions.
Write comprehensive reports documenting interviews and findings.
Lead onsite audits and manage cases referred to law enforcement.
Enhance investigative skills and mentor less experienced team members.
Qualifications
Bachelor's Degree in Criminal Justice or related field, or equivalent experience.
Minimum of 5 years of experience in healthcare fraud investigation/detection.
Proficient in managing large data sets and performing complex calculations.
Excellent communication skills, both verbal and written.
Certified Fraud Examiner (CFE) or similar certification preferred.
Core Technologies
Data Analysis Tools | Word Processing Software | Spreadsheet Software
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:$42.71-$55.53 Per Hr
Description
Join our team as a Special Investigation Unit Investigator III in a remote, contract position.
You will conduct detailed evaluations of potential fraud and abuse cases, leading complex investigations.
The role requires strong analytical skills and expertise in investigative techniques, utilizing various data analysis tools.
Perform in-depth evaluations of potential fraud and abuse cases involving high dollar amounts.
Develop and lead complex investigations, providing mentorship and training to junior investigators.
Ensure adherence to policies and procedures across all product offerings.
Conduct investigation-related training and serve as a subject matter expert.
Compile and maintain comprehensive documentation and reporting requirements.
Participate in hearings and appeals, and testify as a witness in court proceedings.
Develop and maintain strong working relationships with regulatory bodies and law enforcement.
Key Responsibilities
Investigate allegations of healthcare fraud by providers or members.
Analyze data to detect unusual billing patterns and initiate appropriate actions.
Write comprehensive reports documenting interviews and findings.
Lead onsite audits and manage cases referred to law enforcement.
Enhance investigative skills and mentor less experienced team members.
Qualifications
Bachelor's Degree in Criminal Justice or related field, or equivalent experience.
Minimum of 5 years of experience in healthcare fraud investigation/detection.
Proficient in managing large data sets and performing complex calculations.
Excellent communication skills, both verbal and written.
Certified Fraud Examiner (CFE) or similar certification preferred.
Core Technologies
Data Analysis Tools | Word Processing Software | Spreadsheet Software
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 | $42.71–$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
- Analysis Skillsunmatched
- Auditingunmatched
- Billingunmatched
- Certified Financial Examiner (CFE)unmatched
- Communication Skillsunmatched
- Criminal Justiceunmatched
- Data Analysisunmatched
- Data Managementunmatched
- Data Setsunmatched
- Fraud Investigationunmatched
- Healthcareunmatched
- Healthcare Providersunmatched
- Law Enforcementunmatched
- Legalunmatched
- Maintain Complianceunmatched
- Mentoringunmatched
- Onboardingunmatched
- Presentation/Verbal Skillsunmatched
- Procedure Implementationunmatched
- Regulationsunmatched
- Rural Contractsunmatched
- Spreadsheetsunmatched
- Training/Teachingunmatched
- Word Processingunmatched
- Writing Skillsunmatched
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