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Cotiviti · 1 day ago

Senior Investigator (Healthcare FWA)

United States

Full-time

Remote

Mid, Senior Level

$70K/yr - $90K/yr

5+ years exp

Cotiviti is a company focused on healthcare fraud prevention, and they are seeking a Senior Investigator to analyze and investigate suspected incidents of fraud, waste, or abuse in healthcare. The role involves conducting interviews, analyzing data, and supporting legal proceedings while maintaining knowledge of relevant laws and regulations.

Responsibilities

Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse

Conduct interviews or correspond with patients, providers, witnesses or other relevant parties to determine settlement, denial or review

Analyze information gathered by investigation and report findings and recommendations as a written summary and/or presentation

Conducts investigation-related training

Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions

Negotiates settlement agreements to resolve disputes

Maintain current knowledge of relevant laws, regulations and standards

Participates in special projects as required

Qualification

Advanced Excel skillsInvestigative experienceHealthcare fraud knowledgeFraud certificationsListening skillsPrioritization skillsMulti-tasking abilityVerbal communicationWritten communicationAttention to detailOrganizational skills

Required

Bachelor's Degree in related discipline, or the equivalent combination of education, professional training and work experience

5-8 years of related investigative experience

Advanced level skills in Excel

Excellent verbal and written communication skills

Strong listening and observation skills

Attention to detail and high level of accuracy

Effective organizational and prioritization skills with multi-tasking ability

Preferred

Accredited Healthcare Fraud Investigator (AHFI)

Certified Fraud Specialist (CFS)

Certified Fraud Examiner (CFE)

Certified Forensic Interviewer (CFI)

Certified in Healthcare Compliance (CHC)

Benefits

Medical

Dental

Vision

Disability

Life insurance coverage

401(k) savings plans

Paid family leave

9 paid holidays per year

17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti

Company

Cotiviti

Glassdoor3.7

Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States.

Founded in 1979

South Jordan, UT, US

5001-10000 employees