$80,000–$110,000
USD/year
As an Investigative Clinician, you will blend clinical expertise with investigative acumen to detect, prevent, and resolve fraudulent, exaggerated, or non-medically necessary claims. You'll collaborate with adjusters, legal teams, and investigators to analyze medical documentation and uncover inconsistencies or red flags. Responsibilities include reviewing medical records, identifying patterns of fraud, providing clinical expertise, interviewing claimants, and preparing clinical summary reports.