Healthcare Fraud Investigator

Job Summary

A company is looking for an Investigator for the External Audit Special Investigations Unit (Remote).

Key Responsibilities

• Support compliance activities by developing and performing auditing and monitoring tasks
• Identify, investigate, and correct fraudulent billing and coding practices
• Provide education on coding, documentation requirements, and healthcare compliance

Required Qualifications

• Bachelor's Degree or equivalent combination of education and experience
• 5 years of coding experience in a healthcare provider, facility, or health insurance company
• 2 years of fraud and abuse audit experience in a relevant healthcare environment
• Project management and education program development experience
• Experience using data mining software/tools