Lead Fraud Investigator

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary: BASIC FUNCTION: HCSC is looking for a dynamic individual to join its Fraud Investigations team! This position will be responsible for identifying, developing and managing complex, high-impact healthcare fraud investigations resulting in criminal and/or civil prosecution and the misuse of claims, billing, or improper payments. May also be responsible for establishing and maintaining close liaison (as indicated in plan design) with departments/personnel and law enforcement representatives to further the department’s investigation efforts and referral for prosecution of healthcare fraud cases. Will be reviewing transactions, claims, or reports to detect fraud and prepare detailed reports for management, attorneys, or law enforcement and possibly testifying in court. Incumbent conducts complex, large-scale investigations and mentor junior-level investigators. expertise...