Molina Healthcare
Investigator, SIU (Remote)
This job is now closed
Job Description
- Req#: 2023101
Employer Industry: Health Insurance
Why Consider this Job Opportunity:
- Salary up to $44.68/hourly
- Opportunity for career advancement and growth within the organization
- Remote work opportunity
- Collaborative and supportive work environment
- Chance to make a positive impact by preventing health care fraud, waste, and abuse
- Competitive benefits and compensation package
What to Expect (Job Responsibilities):
- Conduct investigations to detect and prevent health care fraud, waste, and abuse
- Perform accurate and reliable medical review audits, including coding and billing reviews
- Analyze information to draw conclusions on allegations of fraud, waste, and abuse
- Produce audit reports for internal and external review
- Coordinate with internal departments and gather documentation pertinent to investigations
What is Required (Qualifications):
- Bachelor's degree or Associate's Degree in criminal justice or equivalent combination of education and experience
- 1-3 years of experience in investigations, unless otherwise required by state contract
- Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations
- Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems
- Strong analytical and problem-solving skills
- Excellent oral and written communication skills
How to Stand Out (Preferred Qualifications):
- At least 5 years of experience in fraud, waste, and abuse or related work
- Health Care Anti-Fraud Associate (HCAFA) certification
- Accredited Health Care Fraud Investigator (AHFI) certification
- Certified Fraud Examiner (CFE) certification
#HealthInsurance #FraudInvestigation #RemoteWorkOpportunity #CareerAdvancement #CompetitivePay
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Molina Healthcare is a managed care company headquartered in Long Beach, California, United States.
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