Senior Analyst, SIU Investigator

This is a fully remote position, open to applicants in Arizona, +2 more states.

📋 Description

• Identify and perform investigations into known or suspected Fraud, Waste, and Abuse with a high degree of autonomy.

• Create documentation to support findings, including detailed reports, graphs, audit logs, and other relevant materials.

• Achieve targets through investigations and enhance internal processes for FWA recoveries and cost savings.

• Review previous cases to aid in the identification of similar claims or cases in the future and the associated savings.

• Assist in transitioning from a “pay-and-chase” model to preventive edits and prepayment activities.

• Engage in the development and delivery of FWA-related training for Oscar teams.

• Adhere to all relevant laws and regulations.

• Undertake additional responsibilities as assigned.

• Report directly to the Investigations Manager, SIU.

⛳️ Requirements

• A minimum of 3 years of experience in insurance claims investigation or professional investigative experience with law enforcement agencies.

• At least 1 year of experience with relevant fraud statutes and regulations, as well as federal guidelines on recoupments and other anti-FWA initiatives.

• Must be a resident of Arizona, Florida, Georgia, or Texas.

• Must have current authorization to work in the United States on a full-time basis.

• Oscar will not sponsor applicants for this position.

🏝️ Benefits

• Employee benefits.

• Unlimited vacation program.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• 401(k) plan participation.

• Life insurance.

• Disability insurance.

• Paid wellness time.

• Wellness reimbursements.

• Occasional travel for team meetings and company events.