Telecommute Healthcare Insurance Investigator in Columbia

Job ID: Available for Members

Location: Maryland

Compensation: To Be Discussed

Staff Reviewed: Mon, Dec 02, 2019

This job expires in 25 days

Job Category: Healthcare, Insurance, Investigations

Telecommute Level: Occasionally

Travel Requirements: Some Travel

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Additional Information: Benefits Available

Job Summary

A healthcare provider has a current position open for a Telecommute Healthcare Insurance Investigator in Columbia.

Core Responsibilities of this position include:

  • Prioritizing, triaging and managing workload to meet internal performance metrics, regulatory and contractual requirements
  • Analyzing data and selecting audit samples using various sampling methodologies
  • Planning and conducting desk audits, field audits and/or site visits

Qualifications for this position include:

  • Site visits
  • A Combination of Education and Work Experience May Be Considered. (Required), Bachelors (Required)
  • Knowledge of managed health care business model and processes, preferably in behavioral health, radiology or pharmacy
  • Minimum of five years of experience in fraud investigations, claims processing, auditing or provider networks
  • Demonstrated abilities in time management and establishing priorities
  • All other requirements necessary for this position