Healthcare Fraud Investigator

Healthcare FraudInvestigator / SIU – Hybrid!HealthCare Support is actively seeking a Healthcare FraudInvestigator II / SIU to join a respected health plan organization, that provides Medicare and Medi-Cal healthcare services to over 1.5 million members in Rancho Cucamonga, California.ScheduleMonday – Thursday 8:00 am – 5:00 pmOnsite Tuesday – Thursday and remote on Mondays and FridaysCompensation$80,000 – $105,000 annually (depending on experience)Annual HEDIS Incentive: Up to 10% Annual Merit Increases: Up to 3% based upon individual performanceBenefitsExceptionally Low Premiums:Medical coverage starting as low as $35/month plus $5/month dental and free vision coverageAffordable Family Coverage: Add a spouse or dependents for as little as $72–$90/month on medical and $10/month for family dentalExceptional Retirement Benefits: CalPERS Pension Plan + 457(b) Retirement Plan with a 3% employer match3 ½ weeks of PTO (18 days) & 11 Paid HolidaysFitness Reimbursement up to $125/a year and on-site fitness facilityTuition reimbursement after 1 year of employmentDaily ResponsibilitiesConducting full investigations to proactively prevent, detect, and correct suspected and identified issues of fraud, waste, and abuse (FWA), including reporting to State and/or Federal regulatory agencies, such as set forth by the CMS, HHS-OIG, DMHC, and DHCS.QualificationsBachelor’s degree from an accredited institutionIn lieu of the required degree, a minimum of 4 years of additional relevant work experience is required for this position (8-years)4+ years relevant professional experience in fraud, waste, and abuse investigations, including Federal and State reporting requirementsExperience in health care fraud investigation, detection, and/or healthcare related specialty including but limited to; Pharmacy, DEM, Mental Health, Behavioral Health, Hospice, Home Health, claims, or claims processingInterested in this opportunity?Click Apply Now for immediate consideration, or reach out to our Recruiter, Melanie Williams with any questions:Call: (407) 346-0844Email:Schedule a Call:https://calendly.com/mw4Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law. Hybrid