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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting audits and investigations into fraud, waste, and abuse, with a strong ability to analyze data, prepare comprehensive reports, and communicate findings effectively. Proficient in coordinating with internal teams to ensure compliance with legal and regulatory standards.
Highest-signal resume keywords
Fraud InvestigationData AnalysisReport PreparationStakeholder CommunicationPrivate Investigator License
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data CollectionDocumentation ReviewInterviewingAudit ProceduresRegulatory Compliance
Soft Skills
Customer ServiceOrganizational SkillsProblem-Solving
Certifications & Qualifications
Private Investigator License
Industry Keywords
FraudWasteAbuseLegal RequirementsAudit Standards
About the role
Key responsibilities & impact- Conduct routine and impartial audits/investigations from start to closure into fraud, waste, and abuse allegations
- Collect and analyze data and information to assess allegation validity
- Review documentation and interview witnesses, claimants, and other stakeholders
- Identify opportunities to proactively target fraud, waste, and abuse
- Address customer inquiries and concerns and escalate matters as needed
- Compile organized records and document all findings
- Prepare recommendations for management and comprehensive reports for legal or audit/investigative purposes
- Communicate findings, updates, and expectations to customers, claimants, and stakeholders
- Coordinate with internal teams to ensure proper processing in compliance with legal and regulatory standards
- Assist with training and supporting other auditors/investigators
- Plan and arrange own work while working with a manager to prioritize projects
Requirements
What you’ll need- Bachelor's Degree required (can be substituted for experience)
- 2–4 years of experience required; 5–7 years preferred (experience can be substituted for education)
- Private investigator license required by customer
- Successful completion of pre-employment background and drug screens
- Ability to collect and analyze data and documentation concerning fraud, waste, and abuse allegations
- Ability to conduct interviews and communicate with stakeholders
- Knowledge of applicable industry regulations, legal requirements, and policies
- Ability to prepare comprehensive reports for legal or audit/investigative purposes
Benefits
Comp & perks- Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities
- Drug-free workplace
- Employment offers contingent upon successful completion of pre-employment background and drug screens
