Note: The job is a remote job and is open to candidates in USA. Cotiviti is a company focused on healthcare fraud, waste, and abuse prevention. As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis and support legal proceedings as needed.

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

Skills

• 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
• 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, and 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

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