SIU Investigator - Analyst

6 days ago

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Oscar

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Award-winning recruitment consultancy; delivering talent across Tech, Digital, Life-Sciences, Energy & Construction

Recruitment • Search and Selection • IT Recruitment • Oil and Gas Recruitment • Contract Recruitment

51 - 200

💰 $140M Private Equity Round on 2020-12

Description

•Investigate change in aberrant behavior observed in claims and enrollment data •Analyze data and manage investigative caseload from identification through to resolution •Conduct investigations into known or suspected FWA with high autonomy •Develop documentation to substantiate findings •Meet targets through investigations and internal process improvements •Perform root cause analysis •Participate in development and presentation of FWA-related education for Oscar teams •Perform coding reviews for flagged claims

Requirements

•Bachelor's degree in Criminal Justice or a related field, OR at least 3 years of insurance claims investigation experience or professional investigation experience with law enforcement agencies •Knowledge of applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity •Experience handling confidential information and following policies, rules, and regulations

Benefits

•Employee benefits •Participation in Oscar’s unlimited vacation program •Annual performance bonuses •Medical, dental, and vision benefits •11 paid holidays •Paid sick time •Paid parental leave •401(k) plan participation •Life and disability insurance •Paid wellness time and reimbursements