Senior Analyst, SIU Investigator

Oscar Health

. Identify and conduct investigations into known or suspected Fraud, Waste, and Abuse with high autonomy .

Posted 9/29/2026full-timeRemote • United StatesSenior💰 $72,036 - $94,547 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in fraud, waste, and abuse investigations, with a strong focus on compliance with applicable laws and regulations. Proficient in developing documentation and reports to support findings and drive process improvements in claims investigations.

Highest-signal resume keywords

Insurance Claims Investigation ExperienceFraud Statutes and Regulations KnowledgeDocumentation Development SkillsProcess Improvement ExpertiseEducation Presentation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Fraud InvestigationDocumentation DevelopmentData AnalysisAudit Log CreationCase AnalysisRegulatory ComplianceClaims RecoupmentPreventive Edits ImplementationInternal Process ImprovementFormal Reporting

Industry Keywords

FraudWasteAbuseFWAInsuranceLaw EnforcementFederal GuidelinesRecoupmentsArizonaFlorida

About the role

Key responsibilities & impact

Identify and conduct investigations into known or suspected Fraud, Waste, and Abuse with high autonomy
Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation
Meet targets through investigations and internal process improvements for FWA recoupments and savings
Analyze prior cases to inform future identification of similar claims or cases and associated savings
Help move from “pay-and-chase” to preventive edits and prepayment activity
Participate in the development and presentation of FWA-related education for Oscar teams
Comply with all applicable laws and regulations
Perform other duties as assigned
Report to the Investigations Manager, SIU

Requirements

What you’ll need

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
Must reside in Arizona, Florida, Georgia, or Texas
Must be currently authorized to work in the United States on a full-time basis
Oscar will not sponsor applicants for this role

Benefits

Comp & perks

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