Investigator, Special Investigative Unit - FLORIDA

Molina
Washington, FL
Category Accounting
Job Description
The Special Investigation Unit (SIU) Investigator is responsible for supporting financial fraud, waste, and abuse recovery. This role involves reviewing medical records, conducting investigations, identifying suspicious billing activity, and producing audit reports. Investigators must adhere to national and local coding guidelines and regulatory requirements while collaborating with internal departments to maintain compliance and oversight.

Requirements

  • Bachelors degree or Associate’s Degree in criminal justice or equivalent
  • 1-3 years experience, unless otherwise required
  • Proven investigatory skill and experience in fraud investigations
  • Knowledge of investigative and law enforcement procedures
  • Understanding of healthcare regulations (Managed Care, Medicaid, Medicare, Marketplace)
  • Valid driver’s license

Benefits

  • Competitive benefits
  • Equal Opportunity Employer (EOE)
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