Special Investigator's Unit Assistant Investigator

What are important things that YOU need to know about this role?

• Remote: This position is open to permanent remote work
• Experience: A minimum of one year of experience in the dental field is required and experience working with FWA (Fraud Waste and Abuse) will be preferred!

What will YOU be doing for us? Support Investigations of allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.

What will YOU be working on every day?

• Assist SIU Investigations with tracking and reporting- what does this mean?
  • Outreach to dental officees for appropriate contact information, status updates and scheduling
  • Retrieve, upload and notification of case files received
  • Assign and schedule case audits with team
  • Document activity on each case and refer issues to the appropriate party
  • Provide case updates on the progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions
  • Prepare summary and/or detailed reports on investigative findings for referral to Federal and State agencies
  • Complete various special projects and audits
• Other Duties as assigned

What qualifications do YOU need to have to be GOOD candidate?

• HS diploma required.
• 1+ years of dental experience.

What qualifications do YOU need to have to be a GREAT candidate?

• 1 year of dental FWA
• Knowledge of Microsoft Applications, dental coding and terminology.
• Business and Criminal Justice Experience
• Investigations
• Dental Claim Audits
• Dental Claim Analysis
• Fraud investigation

The salary range and midpoint is listed below for your reference. Please keep in mind that your education and experience along with your knowledge, skills and abilities are taken into consideration when determining placement within the range.

Compensation Range: $20.28 - $30.42

Compensation Midpoint: $25.35