Job Summary
A health insurance company is searching for a person to fill their position for a Telecommute Healthcare Fraud Investigator II.
Core Responsibilities of this position include:
- Providing claim reviews for appropriate coding, data mining, and entity review
- Identifying and developing enterprise-wide specific healthcare investigations
- Effectively establishing rapport and on-going working relationship with law enforcement
Qualifications for this position include:
- Requires BA/BS degree, 3+ years related experience; or equivalent education and experience
- Knowledge of Plan policies and procedures in all facets of benefit programs management
- Fraud certification from CFE, AHFI, AAPC or coding certificates preferred
