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Fraud Investigator II - Healthcare (REMOTE)
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- Under the general direction of the Associate Director, or designee, the Fraud Investigator II serves a crucial role in combating fraud, waste and abuse (FWA) within the Medicaid program.
- The Investigator II collaborates with the Associate Director on more complex case reviews as needed, in addition to performing activities related to data mining, data analysis and recoveries.
- Conduct independent data mining and data analysis techniques utilizing claims data to detect aberrancies and outliers in claims and develop trends and patterns for potential cases.
- A Bachelors degree in Business administration, finance, public health or related field; or equivalent years of experience.
- 5-7 years of related experience in fraud examination, healthcare, business, finance or related field; with at least 2 years of experience conducting data mining in the healthcare insurance industry and claims related experience.
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