SIU Investigator III

RESPONSIBILITIES:
Kforce has a client that is seeking a SIU Investigator III in Los Angeles, CA. This is a remote position (must live within driving distance from office). The duration is 3 months (CTH). Once you convert to FTE - once a month, onsite is required.

Overview:
The Special Investigation Unit Investigator III performs in-depth evaluation of potential fraud and abuse cases and develops complex investigations that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for fraud, waste, and abuse. In addition, this position is responsible for building the investigative approach and providing leadership for Investigators through mentoring, on-site audit leadership, and hands-on training of investigative techniques.

REQUIREMENTS:
* 5+ years of healthcare fraud, waste, and abuse (FWA) investigations

Healthcare fraud investigation experience within:
* Pharmacy
* DME (Durable Medical Equipment)
* Mental Health/Behavioral Health
* Hospice
* Home Health
* Dental

* Experience conducting investigations and fact-finding interviews
* Experience analyzing claims data and detecting unusual billing patterns

Advanced Excel skills:
* Pivot Tables
* Complex formulas/calculations
* Comparing large datasets
* Experience writing investigative reports and documenting findings
* Knowledge of Medicare and/or Medi-Cal fraud investigations
* Ability to support conclusions with documented evidence

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

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