Erin Lewis

Senior SIU Healthcare Fraud Investigator HealthCare Support is actively seeking an Senior SIU Healthcare Fraud Investigator to fill an opening in Los Angeles, California. Daily Responsibilities for Senior SIU Healthcare Fraud Investigator:

• Responsible for in-depth investigations requiring subject matter expertise for suspected provider, pharmacy, employer or member fraud or abuse across all products at L.A. Care Health Plan. Ensures adherence to L.A. Care's policies and procedures for its various product offerings. Conducts investigation-related training. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.
• Participates in industry meetings/trainings and is able to effectively share and gather significant information.  Develops and maintains strong working relationships with associates and regulators including DHCS, DOJ the FBI, Local Law Enforcement, Prosecutors, etc. Continually enhances investigative skills and understanding of emerging issues and trends impacting the industry.
• Monday - Friday 8AM to 5PM (PST)

Required Qualifications for Senior SIU Healthcare Fraud Investigator:

• Bachelor’s degree in criminal justice or Related Field (Prefer Master’s Degree) – will consider 9 years of experience in exchange for no degree
• 5+ years in healthcare fraud investigation/detection
• Computer skills: ability to use multiple program/screens at the same time, MS Word, MS Excel, MS Access

Preferred Qualifications for Senior SIU Healthcare Fraud Investigator:

• Managed Care experience strongly preferred
• Certified Fraud Examiner (CFE)
• Accredited Health Care Fraud Investigator (AHFI)
• Certified Professional Coder (CPC) designation by the American Academy of Professional Coders

Benefits for Senior SIU Healthcare Fraud Investigator:

• Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts
• Career and educational tools within our Ingenovis ACT (advocacy) Program

Pay Details: $42.73- $55.53/Hour Interested in Being Considered? If you are interested in applying to this position, please click Apply Now for immediate consideration. For additional questions, you may contact us at [email protected]. Please include your phone number, Job Title, and location and our recruiters will reach out. Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.