Job Summary
A healthcare company is searching for a person to fill their position for a Remote Fraud and Abuse Specialist Coder in Pittsburgh.
Core Responsibilities Include:
- Acting as a liaison with key internal contacts in the investigation and prosecution of insurance F&A
- Performing investigations and/or audits resulting from fraud and abuse (F&A) referrals
- Acting as a liaison with the DPW, BPI, CMS, PID, the IFPA, local, county, state, and federal law enforcement agencies
Qualifications for this position include:
- Testify in a court of law as needed
- Bachelor's degree in a related field (or equivalent years of experience) required
- 3 years of experience in health insurance
- Experience should include claims processing, coding, auditing, underwriting, and/or information systems
