California Licensed Audit Investigator

Job Summary

A company is looking for an Investigator for the External Audit Special Investigations Unit, working remotely.

Key Responsibilities

• Support compliance activities by developing, implementing, and performing auditing and monitoring tasks
• Identify, investigate, and correct fraudulent billing and coding practices, coordinating recovery of overpayments
• Provide education on coding, medical record documentation, and healthcare compliance to staff and providers

Required Qualifications

• Bachelor's Degree or equivalent combination of education and experience
• 5 years of coding experience in a healthcare setting
• 2 years of fraud and abuse audit experience in a relevant healthcare environment
• Experience in project management and education program development
• Familiarity with data mining software/tools