Medicare Fraud Investigator — Remote Telework

Peraton; Idaho, United States, Northern America, Americas; Híbrido; USD 66.000 - 106.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Telework

Descripción de la vacante

Peraton is seeking a Fraud Investigator for SafeGuard Services to perform high level investigations of medical providers, develop cases for action, and coordinate with law enforcement or other authorities. The role emphasizes confidentiality in handling health privacy data and preparing detailed investigative reports.

The ideal candidate will have extensive investigative experience, strong communication and organizational abilities, and the flexibility to work with state and federal partners.

Formación

• 5 years with BS/BA or 9 years with HS Diploma/equivalent
• 5 to 6 years investigative experience
• Strong investigative skills
• Strong communication and organization skills
• Strong PC knowledge and skills
• US Citizenship is required

Responsabilidades

• Perform high level complex investigations of medical professional service providers and develop cases for action.
• Coordinate with internal resources and external agencies to develop cases and corrective actions.
• Prepare investigation reports applying regulations and, when needed, federal or state laws.
• Interview witnesses, obtain statements and organize case files with thorough documentation.
• Maintain confidentiality regarding health privacy and respond to data requests.
• Provide training on investigative tools and develop fraud detection expertise.
• Occasionally testify in court and work to address issues with appropriate stakeholders.

Conocimientos

Investigative skills

Communication skills

Organization skills

PC knowledge

US Citizenship

Educación

BS/BA or 9 years with HS Diploma/equivalent

Descripción del empleo

Peraton is seeking a Fraud Investigator for SafeGuard Services to perform high level investigations of medical providers, develop cases for action, and coordinate with law enforcement or other authorities. The role emphasizes confidentiality in handling health privacy data and preparing detailed investigative reports.

The ideal candidate will have extensive investigative experience, strong communication and organizational abilities, and the flexibility to work with state and federal partners.