Senior Fraud Investigations Analyst

Role Overview

• Conducts investigations in accordance with investigative action plan and documents all findings in standard with SIU Policies and Procedures
• Identifies errors and control deficiencies.
• May be required to provide deposition and/or testimony
• Conduct interviews of victims, subjects and/or other related persons
• Prepares and conducts presentations and/or provides content for health care fraud and abuse education and awareness.

Requirements

• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.
• Working knowledge of Medicare programs and reimbursement principles, including general billing requirements and documentation expectations
• Professional certifications such as AHFI (Accredited Healthcare Fraud Investigator), CFE (Certified Fraud Examiner), or similar healthcare fraud or compliance credentials
• Experience reviewing and vetting investigative leads and determining appropriate next steps
• Strong Excel skills for organizing, tracking, and reviewing case data (e.g., filtering, sorting, basic formulas, pivot tables)

Benefits

• Medical, dental, and vision coverage along with numerous health and wellness programs.
• Parental leave and support plus adoption and surrogacy assistance.
• Career development programs and tuition reimbursement for continued education.
• 401k match including an annual company contribution