SIU/FWA Investigator

Solis Health Plans

Miami, Florida, United States or United StatesRemoteFull Time$50,000–$60,000 yearMid LevelBachelors DegreeUnknown

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Posted 7 months ago

Job Summary

The SIU/FWA Investigator will investigate allegations of healthcare fraud and abuse, conduct audits, perform data analysis, and coordinate with health plans to resolve cases. Requires a Bachelor's degree and 1+ years of relevant experience.

Required Qualifications

Bachelor’s degree in business, Criminal Justice, Healthcare, related field or equivalent experience
1+ years of experience in medical claims investigation, auditing, and analysis within a Managed Care Environment
Knowledge of medical coding and terminology
Advanced Proficiency in Microsoft Excel, Data Analysis and Fraud Detection

Desired Qualifications

Advanced skills in SQL, SAS and business intelligence (BI) tools