CPC Certified Fraud Investigator

Job Summary

A company is looking for a Fraud and Abuse Investigator/CPC for a remote position.

Key Responsibilities

• Conduct in-depth investigations for suspected fraud or abuse related to various healthcare interactions
• Review the quality of coding through routine and occasional audits
• Analyze reimbursement systems and ensure compliance with policies and procedures

Required Qualifications, Training, and Education

• Bachelor's Degree required; related field preferred
• Minimum of 2 years combined experience in Medical Coding, Healthcare, Internal/External Audit, or related fields required
• Certified Professional Coder (CPC) required (or to be achieved within 12 months of hire)
• Preferred certifications include Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI)
• Additional preferred certifications include Certified Forensic Interviewer (CFI) and Certified in Healthcare Compliance (CHC)