[Remote] Senior Investigator - Lead Validation (Healthcare FWA)

Note: The job is a remote job and is open to candidates in USA. Cotiviti is a leading company in the healthcare sector, and they are seeking a Senior Investigator to join their Fraud, Waste, and Abuse team. The Senior Investigator will be responsible for investigating suspected incidents of healthcare fraud, waste, or abuse through data analysis and monitoring provider activity to identify patterns and anomalies that may require further investigation.ResponsibilitiesIdentify, investigate, analyze and evaluate instances of potential fraud, waste, and abuseProactively monitors provider activity to identify patterns, anomalies, and emerging trends that may warrant further investigationUtilizes data analytics, claims review, and industry intelligence to detect potential fraud, waste, abuse, or non-complianceLeverages claims data, dashboards, and predictive models to identify providers exhibiting atypical billing patterns or potential fraud, waste, and abuseAnalyze information gathered by investigation and report findings and recommendations as a written summary and/or presentationConducts investigation-related trainingSupports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actionsMaintain current knowledge of relevant laws, regulations and standardsParticipates in special projects as requiredComplete all responsibilities as outlined on annual Performance PlanComplete all special projects and other duties as assignedMust be able to perform duties with or without reasonable accommodationSkillsBachelor's Degree in related discipline, or the equivalent combination of education, professional training and work experience5-8 years of related FWA investigative experienceExperience in proactive data miningExperience in sampling and data extrapolation; prior use with RAT-STATS preferredAdvanced level skills in Excel requiredExcellent verbal and written communication skillsStrong listening and observation skillsAttention to detail and high level of accuracyEffective organizational and prioritization skills with multi-tasking abilityExperience using Cotiviti FWA tools (preferred) - Sentinel, Commander, and/or Informant (Stars Solutions)Preferred certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Specialist (CFS), Certified Fraud Examiner (CFE), Certified Forensic Interviewer (CFI), or Certified in Healthcare Compliance (CHC)BenefitsMedical, dental, vision, disability, and life insurance coverage401(k) savings plansPaid family leave9 paid holidays per year17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with CotivitiCompany OverviewCotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. It was founded in 1979, and is headquartered in South Jordan, UT, US, with a workforce of 5001-10000 employees. Its website is http://www.cotiviti.com.