SIU Analyst – Investigator

Integrity Management Services, Inc.

SIU Analyst/Investigator ensuring compliance and accuracy in healthcare claims through audits and analyses. Collaborating with clinical SMEs and managing investigative caseload for FWA recoupments.

Posted 4/15/2026full-timeRemote • Virginia • 🇺🇸 United StatesJuniorMid-LevelWebsite

About the role

Key responsibilities & impact

Identify and conduct investigations into known or suspected FWA with high autonomy
Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation.
Perform root cause analysis to inform future algorithmic identification of similar claims or cases and associated savings (i.e., help move identified case types from "pay-and-chase" to preventive edits and pre-payment activity)
Participate in the development and presentation of FWA-related education for assigned Customers
Perform coding reviews for flagged claims, to support Coding team (if applicable).

Requirements

What you’ll need

Education:
- 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.
- Experience:
- Minimum of 2 years of experience in healthcare claims analysis, auditing, payment integrity, or a related field.
- 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
- Experience with commercial, Medicare, or Medicaid claims is highly preferred.
- Skills:
- Strong analytical and problem-solving skills, with attention to detail and accuracy.
- Excellent communication skills, both written and verbal, for effective collaboration with internal teams and external providers.
- Proficiency in Microsoft Office, particularly Excel, and familiarity with claims processing or audit software is a plus.

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Integrity Management Services, Inc. Website LinkedIn All Job Openings 51 - 200 employees 📋 Compliance 🏛️ Government 🎯 Recruiter Compliance
Government
Recruitment Integrity Management Services, Inc. is a women-owned, women-run company specializing in helping government and commercial enterprises minimize the risk of improper payments, fraud, waste, and abuse. The company provides a range of services including data analytics, fraud investigations, compliance reviews, audits, grants management, staff augmentation, and coding and medical reviews. IntegrityM, as they are known, works closely with Federal Government agencies, state agencies, and private sector organizations to drive informed decisions and enhance program transparency and oversight. The company is recognized for its contributions to the community and has been awarded for excellence in government contracting and corporate social responsibility. SIU Analyst – Investigator Job not on LinkedIn 🔥 28 minutes ago ⚔️ Virginia – Remote ⏰ Full Time 🟢 Junior 🟡 Mid-level 🧐 Analyst Apply Now Find Hiring Managers Customize resume for this job Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Identify and conduct investigations into known or suspected FWA with high autonomy
Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation.
Perform root cause analysis to inform future algorithmic identification of similar claims or cases and associated savings (i.e., help move identified case types from "pay-and-chase" to preventive edits and pre-payment activity)
Participate in the development and presentation of FWA-related education for assigned Customers
Perform coding reviews for flagged claims, to support Coding team (if applicable). 🎯 Requirements
Education:
- 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.
- Experience:
- Minimum of 2 years of experience in healthcare claims analysis, auditing, payment integrity, or a related field.
- 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
- Experience with commercial, Medicare, or Medicaid claims is highly preferred.
- Skills:
- Strong analytical and problem-solving skills, with attention to detail and accuracy.
- Excellent communication skills, both written and verbal, for effective collaboration with internal teams and external providers.
- Proficiency in Microsoft Office, particularly Excel, and familiarity with claims processing or audit software is a plus. Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Analyst, Analytics – Performance Insights 🔥 35 minutes ago Capital Rx 501 - 1000 ⚕️ Healthcare Insurance 💳 Fintech 🤖 Artificial Intelligence Website LinkedIn All Job Openings Analyst supporting data-driven projects and reporting initiatives for healthcare technology company Judi Health. Contributing to team collaboration and data-informed decision-making. 🇺🇸 United States – Remote 💵 $75k - $85k / year ⏰ Full Time 🟢 Junior 🟡 Mid-level 🧐 Analyst Data Exchange Analyst 🔥 35 minutes ago Capital Rx 501 - 1000 ⚕️ Healthcare Insurance 💳 Fintech 🤖 Artificial Intelligence Website LinkedIn All Job Openings Analyst role managing data and customer relationships in health technology company. Contributing to claims processing and client onboarding in innovative pharmacy solutions. 🇺🇸 United States – Remote 💵 $76.8k - $121k / year ⏰ Full Time 🟢 Junior 🧐 Analyst Medical Economics Analyst 🔥 1 hour ago Interwell Health 501 - 1000 ⚕️ Healthcare Insurance 🧘 Wellness Website LinkedIn All Job Openings Analyst supporting actuarial and financial reporting functions in kidney care management company. Conducting data analysis, experience studies, and medical trend evaluations to inform business decisions. 🇺🇸 United States – Remote 💰 $46M Series B on 2021-04 ⏰ Full Time 🟢 Junior 🧐 Analyst Assistant Clinical Analyst I 🔥 2 hours ago GeneDx 1001 - 5000 Website LinkedIn All Job Openings Assistant Clinical Analyst I at GeneDx supporting the interpretation of genetic findings and case resolution. Aiding clinical data analysis and maintaining quality standards in the diagnosis process. 🇺🇸 United States – Remote 💵 $90k - $103k / year ⏰ Full Time 🟢 Junior 🧐 Analyst Digital Commerce Analyst – Amazon 🔥 3 hours ago Radio Systems Corporation 501 - 1000 👥 B2C 🛒 Retail 🧘 Wellness Website LinkedIn All Job Openings Digital Commerce Analyst supporting the execution of Amazon 1P business operations. Driving growth and performance through data insights and collaboration with the Sr. National Account Manager. 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst 🦅 H1B Visa Sponsor View More Analyst Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Hard Skills & Tools

investigationsroot cause analysiscoding reviewshealthcare claims analysisauditingpayment integrityfraud statutesregulationsclaims processingaudit software

Soft Skills

analytical skillsproblem-solving skillsattention to detailaccuracycommunication skillscollaboration