• Job Description

  Req#: 2184551
  Employer is offering an exciting opportunity for candidates who want to be part of inventing the future of healthcare. By joining Employer, candidates can help people live healthier lives while making a significant impact in the field of healthcare.
  
  Primary Responsibilities:
  - Investigate highly complex cases of Fraud, Waste, and Abuse (FWA)
  - Detect fraudulent activity by beneficiaries, providers, and other parties against government contracts
  - Develop and deploy effective and efficient investigative strategies for each investigation
  - Maintain accurate and thorough case information in the case tracking system
  - Collect and secure documentation or evidence and prepare summaries of findings
  
  Required Qualifications:
  - 5+ years of experience in health care Fraud, Waste, and Abuse (FWA)
  - 5+ years of experience conducting or managing comprehensive research to identify billing abnormalities, questionable billing practices, irregularities, and fraudulent or abusive billing activity
  - Experience with federal FWA programs and contracts
  - Demonstrated knowledge of applicable medical terminology and coding guidelines (e.g., CPT, HCPCS, ICD-9, ICD-10)
  - Demonstrated understanding of how claims are processed and adjudicated
  
  Preferred Qualifications:
  - Accredited Health Care Fraud Investigator (AHFI)
  - Certified Fraud Examiner (CFE)
  - 5+ years of experience developing investigative strategies
  - Advanced knowledge and experience of Statistical Analysis
  - Proficiency in performing financial and statistical analysis including statistical calculation and interpretation
  
  Additional Information:
  - California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $85,000 to $167,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to salary, Employer offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when a candidate begins a career with Employer, they'll find a far-reaching choice of benefits and incentives.
  - All employees working remotely will be required to adhere to Employer's Telecommuter Policy.
  - Employer is committed to helping people live healthier lives and making the health system work better for everyone. Employer believes that everyone, regardless of race, gender, sexuality, age, location, or income, deserves the opportunity to live their healthiest life. Employer is committed to mitigating its impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in their mission.
  - Diversity creates a healthier atmosphere: Employer is an Equal Employment Opportunity/Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
  - Employer is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

• About the company

  The best remote jobs for you

Notice