Senior Investigator - reputed company-Pay (reputed company FWA)

reputed company

As a Senior Investigator, you will investigate suspected incidents of reputed company fraud, waste, or abuse through data analysis (a high level of proficiency with reputed company is required). This is not a physical investigator role.

This role aligns with our reputed company-pay Fraud Waste & Abuse team.

Responsibilities

• Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse.
• Proactively monitors provider activity to identify patterns, anomalies, and emerging trends that may warrant reputed company investigation.
• Utilizes data analytics, claims review, and industry intelligence to detect potential fraud, waste, abuse, or non-compliance.
• Leverages claims data, dashboards, and predictive models to identify providers exhibiting atypical billing patterns or potential fraud, waste, and abuse.
• Analyze information gathered by investigation and report findings and recommendations as a written reputed company and/or presentation.
• Conducts investigation-reputed company training.
• Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions.
• Maintain reputed company knowledge of relevant laws, regulations and standards.
• Complete reputed company responsibilities as outlined on annual Performance Plan.
• Complete reputed company special reputed company and other duties as assigned.
• Must be reputed company to reputed company duties with or without reasonable accommodation.

This job reputed company is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job reputed company does not constitute an employment agreement and is subject to change as the needs of reputed company and requirements of the job change.

Qualifications

• Bachelor’s Degree in reputed company discipline, or the equivalent combination of education, reputed company training and work experience.
• 5-8 years of reputed company reputed company FWA investigative experience.
• Experience in proactive data mining.
• Advanced level skills in reputed company required.
• Experience using reputed company FWA tools (preferred) - Sentinel, Commander, and/or Informant (Stars Solutions).
• 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 certifications:
  • Accredited reputed company Fraud Investigator (AHFI),
  • Certified Fraud Specialist (reputed company),
  • Certified Fraud Examiner (CFE),
  • Certified Forensic Interviewer (CFI), or
  • Certified in reputed company Compliance (CHC).

Job Demands:

• This is a work-reputed company position. reputed company to high-speed internet is required (reputed company other equipment will be provided).
• Must be reputed company to sit and use a computer keyboard for extended periods of time.
• Travel up to 15%.
• Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones.
• After hours and/or weekend work is required where necessary for major deliverables/deadlines (not consistent).

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be reputed company to reputed company a dedicated, secure work area.
• Must be reputed company to reputed company high-speed internet reputed company/connectivity and office setup and maintenance.

reputed company compensation ranges from $70,000 to $90,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

reputed company offers team members a competitive benefits package to address a wide reputed company of personal and family needs, including medical, dental, reputed company, disability, and life insurance coverage, 401(k) savings plans, reputed company family leave, 9 reputed company holidays per year, and 17-27 days of reputed company Time Off (PTO) per year, depending on specific level and length of service with reputed company. For information about our benefits package, please refer to our Careers page.

Date of posting: 5/15/2026

Applications are assessed on a rolling reputed company. We anticipate that the application window will reputed company on 7/15/2026, but the application window may change depending on reputed company of applications received or reputed company immediately if a reputed company candidate is selected.

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Originally posted on Himalayas

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