PA Licensed SIU Supervisor

A company is looking for a Supervisor, SIU. Key Responsibilities Supervise the Special Investigation Unit staff to ensure compliance with investigative timelines and processes Review and validate reports related to fraud, waste, and abuse, providing recommendations to health plans and regulators Monitor case progress in tracking systems and develop new investigative leads through data analysis Required Qualifications Bachelor's degree in Business, Healthcare, Criminal Justice, or related field, or equivalent experience 3+ years of medical claim or fraud investigation experience Knowledge of Excel, medical coding, claims processing, and data mining preferred Previous experience in a lead role or managing cross-functional teams is preferred Medical records or coding license preferred

Apr 11, 2025 - 22:39

A company is looking for a Supervisor, SIU. Key Responsibilities Supervise the Special Investigation Unit staff to ensure compliance with investigative timelines and processes Review and validate reports related to fraud, waste, and abuse, providing recommendations to health plans and regulators Monitor case progress in tracking systems and develop new investigative leads through data analysis Required Qualifications Bachelor's degree in Business, Healthcare, Criminal Justice, or related field, or equivalent experience 3+ years of medical claim or fraud investigation experience Knowledge of Excel, medical coding, claims processing, and data mining preferred Previous experience in a lead role or managing cross-functional teams is preferred Medical records or coding license preferred