Job Summary
A healthcare company needs applicants for an opening for a Remote Healthcare Fraud Investigator II in Louisville.
Must be able to:
- Perform claim reviews for appropriate coding, data mining, entity review, law enforcement referral
- Effectively establish rapport and on-going working relationship with law enforcement
- Assist in the development of policy and/or procedures to prevent loss of company assets
Skills and Requirements Include:
- BA/BS and minimum of 3 years related experience
- Fraud certification from CFE, AHFI, AAPC or coding certificates
- Knowledge of Plan policies and procedures in all facets of benefit programs management
- Health insurance, law enforcement experience
