Investigator (Fraud, Waste & Abuse)

Cotiviti

12d • $60,000 - $78,000 • Remote

About The Position

The Investigator will work as part of a team responsible for investigating Healthcare Fraud, Waste or Abuse. This position partners with more senior investigators and will focus on both analyzing healthcare data, identifying potential FWA, and conducting interviews. This position can be done remote, from your home, in the continental United States.

Requirements

• Bachelor’s Degree in related discipline, or the equivalent combination of education, professional training and work experience.
• 2-5 years of related investigative experience.
• Excellent verbal and written communication skills.
• Strong listening and observation skills.
• Attention to detail and a high level of accuracy.
• Effective organizational and prioritization skills with a multi-tasking ability.

Nice To Haves

• Accredited Healthcare Fraud Investigator (AHFI).
• Certified Fraud Examiner (CFE).
• Certified Professional Coder (CPC).
• Certified Forensic Interviewer (CFI).
• Certified in Healthcare Compliance (CHC).

Responsibilities

• Investigate suspected incidents of fraud, waste or abuse.
• Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse.
• Conduct interviews or correspond with patients, providers, witnesses or other relevant parties to determine settlement, denial, or review.
• Analyze information gathered by investigation and report findings and recommendations as a written summary and/or presentation.
• Conducts statistical sampling of complex medical claims.
• Assists in drafting settlements.
• Participates in special projects as required.

Benefits

• Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level