Oscar is an AI operations analyst that watches every location 24/7, catching revenue leaks, labor inefficiencies, and compliance risks, then delivering the alerts, reports, and action plans your team needs to fix them fast. Backed by Techstars.
About the role
The Senior Analyst, Special Investigations Unit Investigator detects, investigates, and produces change in aberrant behavior observed in claims and enrollment data. You will analyze data and manage investigative caseload from identification through to resolution including overpayment recovery, measuring behavior change and completing necessary reporting to meet monetary and caseload targets through investigations and internal process improvements for Fraud Waste and Abuse (FWA) recoupments and savings. Found on 1752vc Careers, the job board for startup and VC roles.
What they're looking for
- 3+ years of insurance claims investigation experience or professional investigation experience with law enforcement agencies
- 1+ year experience with applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity
More about this role
Hi, we're Oscar. We're hiring a Senior Analyst, SIU Investigator to join our SIU team.
Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
The Senior Analyst, Special Investigations Unit Investigator detects, investigates, and produces change in aberrant behavior observed in claims and enrollment data. You will analyze data and manage investigative caseload from identification through to resolution including overpayment recovery, measuring behavior change and completing necessary reporting to meet monetary and caseload targets through investigations and internal process improvements for Fraud Waste and Abuse (FWA) recoupments and savings.
You will report into the Investigations Manager, SIU.
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote
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