SIU Investigative Analyst III (ATL)

The Intersect Group

Los Angeles, CA(remote)

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JOB DETAILS

SALARY

$32–$41.99 Per Hour

SKILLS

Analysis Skills, C++ Active Template Libraries (ATL), Case Management, Claims Processing, Coding Standards, Communication Skills, Content Management Systems (CMS), Current Procedural Terminology (CPT), Customer Support/Service, Data Analysis, Detail Oriented, Environmental Impact, Fraud Investigation, Healthcare, Healthcare Common Procedure Coding System (HCPCS), ICD-10, Investigative Reports, Medicaid, Medical Coding, Medicare, Mentoring, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Multilingual, Organizational Skills, Pattern Analysis, Presentation/Verbal Skills, Public Health, Quality Management, Regulations, Regulatory Reports, Regulatory Requirements, Regulatory Submissions, Spanish Language, Time Management

LOCATION

Los Angeles, CA

POSTED

30+ days ago

SIU Investigative Analyst III - Healthcare
Remote Opportunity West Coast Hours
Pay Rate: $32 to 41.99 per hour
Type: Contract Opportunity 16 Weeks

Company Overview
The Intersect Group partners with mission driven healthcare organizations committed to improving access, quality, and equity for underserved populations. Our client supports large scale public healthcare programs and emphasizes compliance, accountability, and innovation to protect critical resources. This is an opportunity to contribute to meaningful work in a highly regulated and impactful environment.

Role Summary
The SIU Investigative Analyst III plays a key role in the intake, triage, and regulatory reporting of healthcare fraud leads across multiple systems and channels. This position ensures timely and compliant reporting while supporting investigators through advanced data analysis and case development.

You will act as a subject matter expert, overseeing reporting processes, analyzing fraud patterns, and collaborating with internal teams and regulatory agencies to strengthen program integrity.

Key Responsibilities
Oversee intake and triage of investigative leads including hotline complaints, referrals, and regulatory submissions
Ensure all federal and state reporting requirements are met within mandated timelines
Analyze claims, provider data, and referral information to identify suspicious patterns and potential fraud
Maintain and support case management systems including healthcare fraud tracking and reporting tools
Serve as a subject matter expert for reporting systems and act as a liaison for system enhancements
Prepare clear, concise investigative and analytical reports to support case development
Collaborate with investigators to provide data analysis support on complex cases
Train and mentor junior team members on processes, systems, and reporting standards

Key Requirements
Minimum 4 years of experience in healthcare fraud investigation or detection
Strong knowledge of regulatory reporting requirements for Medicare, Medicaid, and related programs
Proficiency in healthcare coding standards including CPT, HCPCS, ICD 10, CMS 1500, and UB04
Experience with healthcare data systems such as HCFS, HPMS, or similar case management platforms
Strong data analysis skills with proficiency in Excel, Word, PowerPoint, and reporting tools
Knowledge of healthcare operations, claims processing, and fraud detection methodologies
Excellent organizational skills with the ability to manage high volume workloads and strict deadlines
Strong communication skills with the ability to present findings clearly and accurately

Preferred Qualifications
Experience within SIU or payment integrity environments
Certified Medical Coder or Accredited Healthcare Fraud Investigator designation
Familiarity with Medi Cal, Medicare, or Medicaid programs
Bilingual capabilities in Spanish or other commonly spoken languages

Call to Action
If you are a detail oriented analytical professional with experience in healthcare fraud detection and regulatory reporting, The Intersect Group encourages you to apply today. Submit your resume and contact information for immediate consideration.

About the Company

The Intersect Group

The Intersect Group is a different and better business partner. We create unparalleled value for our clients by combining industry-leading Consulting capabilities with comprehensive Staffing and recruitment services. Clients trust us to deliver results based on our deep expertise and proven resources within finance, accounting, and information technology. Through our flexible delivery approach, you get the right solution, at the right time to accelerate your success and achieve all of your mission-critical objectives.

COMPANY SIZE

500 to 999 employees

INDUSTRY

Staffing/Employment Agencies

FOUNDED

2006