How Remoteville checks and expires listings
Senior Compliance Investigator
Skills
Analytical SkillsFraud InvestigationsGEDHealth InsuranceHealthcareLeadershipManaged Care
What the job involves
The main requirements, responsibilities and hiring steps.
Requirements
- Bachelor's degree in a related field or Associate's degree with 5 years of applicable experience or High School/GED with 6 years of applicable experience
- 4+ years of experience in investigations auditing and risk analysis
- 1+ year of experience reading analyzing and interpreting state and federal laws rules and regulations
Nice to have
- Analytical
- Detail-oriented
- Collaborative
- Leadership
- Organized
Day to day
- Leads and conducts compliance and ethics investigations across business units and health plans
- Reviews allegations documents witness statements and regulatory criteria to determine findings
- Prepares clear investigation reports summarizes trends and recommends remedial or disciplinary actions