Senior Investigator (Healthcare FWA)

Job description

Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role. This role aligns with our post-pay Fraud Waste & Abuse team. Responsibilities: This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change. - Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse. - Conduct interviews or correspond with patients, providers, witnesses or other relevant parties to determine settlement, denial or review. - Analyze information gathered by investigation and report findings and recommendations as a written summary and/or presentation. - Conducts investigation-related training. - Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civ...