An associate's or bachelor's degree in criminal justice or a related field
* A minimum of five years in the healthcare field working in fraud, waste, and abuse investigations and audits; or
* A minimum of five years of insurance claims investigation or law enforcement investigation experience; or
* A minimum of seven years of professional investigation experience involving economic or insurance related matters
Ability to develop fraud investigations
An intermediate or better level of proficiency in Microsoft Office.
User knowledge of health care related computer systems/applications.
Knowledge of HCPCS, ICD-10CM, and CPT required.
Knowledge of reviewing medical records/documentation required