Investigator II – Behavioral Health
Roanoke, Ohio, United States of America
Full Time
6 days ago
$67,640 - $101,460 USD
Visa Sponsor
Key skills
Data Mining
About this role
Role Overview
- Responsible for the identification and investigation of healthcare fraud cases
- Claim reviews for appropriate coding, data mining, and entity review
- Establish rapport and ongoing working relationship with law enforcement
- Assist in training of internal and external entities
- Develop policies and procedures to prevent loss of company assets
Requirements
- Requires a BA/BS degree
- Minimum of 3 years related experience
- Fraud certification from CFE, AHFI, AAPC or coding certificates preferred
- Knowledge of Plan policies and procedures in all facets of benefit programs management
- Health insurance, law enforcement experience preferred
Benefits
- Health insurance
- 401(k) matching
- Paid time off
- Flexible working hours
- Incentive and recognition programs
- Equity stock purchase
- Wellness programs