Special Investigation Unit (SIU)
Insurance Fraud Investigator (SIU - Healthcare Claims)
Key Responsibilities
- Investigate suspected healthcare fraud schemes including phantom provider billing, unbundled services, kickbacks, and staged medical treatments.
- Perform background investigations, claimant and witness interviews, and recorded examinations under oath (EUO).
- Synthesize medical records, provider billing patterns, and financial data to assemble comprehensive litigation packages.
- Liaise with state insurance fraud bureaus, the National Health Care Anti-Fraud Association (NHCAA), and federal law enforcement agencies.
What We Are Looking For
- 4+ years of Special Investigation Unit (SIU) experience or previous background in financial / healthcare criminal investigations.
- Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designation preferred.
- Comprehensive knowledge of healthcare fraud statutes, False Claims Act, and state insurance reporting laws.
- Exceptional interview techniques and clear, courtroom-ready investigative reporting skills.
Core Technologies & Methodologies
Insurance Fraud Investigation
SIU
CFE / CIFI
False Claims Act
Medical Billing Fraud
Witness Interrogation
Law Enforcement Referral
Why Build Your Career at Oakbridge?
Elite Toolsets
Direct architecture experience with Domo, Snowflake, Databricks, AWS, dbt, and modern LLM APIs.
Remote Autonomy
High-trust asynchronous collaboration, flexible hours, and healthy work-life integration.
Paid Certifications
100% funded Domo, Snowflake SnowPro, and AWS Solution Architect certifications.
Competitive Pay
Above-market salary tiers, performance bonuses, and dedicated modern hardware stipends.