SIU Clinical Healthcare Fraud Investigator III

Mitchell Martin

Los Angeles, CA(remote)

JOB DETAILS
SALARY
$45–$55.53 Per Hour
SKILLS
Billing, Clinical Study Publications, Cross-Functional, Documentation Review, Drug Development, Fraud Investigation, Healthcare, Law Enforcement, Mentoring, Onboarding, Pattern Analysis, Regulations, Regulatory Compliance, Reimbursement, Reporting Skills, Strategic Planning
LOCATION
Los Angeles, CA
POSTED
6 days ago
Title: SIU Clinical Healthcare Fraud Investigator III

Location:Remote
Position Type: Contract

Compensation
Pay Range:$45.00-$55.53 Per Hr

Description
Lead complex investigations into suspected healthcare fraud, waste, and abuse.
Independently manage investigations from intake through closure.
Develop strategies and prepare evidentiary packages for referrals.
Collaborate cross-functionally to safeguard organizational integrity.
Provide clinical and operational insight into billing patterns.
Act as a resource and mentor for other staff.

Key Responsibilities
Conduct complex clinical investigations involving misconduct.
Coordinate with law enforcement and regulatory agencies.
Analyze patterns and emerging schemes in healthcare fraud.
Prepare comprehensive reports and referral packets.
Mentor junior investigators and contribute to detection controls.

Qualifications
At least 4 years of coding experience.
At least 3 years conducting healthcare fraud investigations.
Expertise in clinical documentation review and regulatory compliance.
Strong understanding of coding and reimbursement structures.
Proven ability to mentor others and manage multiple investigations.

Contact Authorization:
By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy here https://www.mitchellmartin.com/privacy-policy. 

Onboarding Expectations
Learn more about our Onboarding Process here https://youtu.be/rjV_NFYjyY4  

EEO Statement
Learn more about our EEO policy here https://www.mitchellmartin.com/eoe-statement  

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About the Company

M

Mitchell Martin

OUR FOCUS IS GROWTH

It’s not just about filling job openings.  It’s about enabling growth and inspiring success.  That’s what we do.

Mitchell Martin is one of the nation’s largest staffing companies, with offices throughout the US as well as in India and the Philippines.  We help drive success for both people and companies by helping them achieve positive growth.   We do this by building strong relationships and developing a deep understanding of the people we work with, in order to facilitate the best matches for both sides of the equation.    

COMPANY SIZE
100 to 499 employees
INDUSTRY
Staffing/Employment Agencies
FOUNDED
1984
WEBSITE
https://www.mitchellmartin.com