Oregon Licensed Audit Investigator

A company is looking for an Investigator External Audit in the Special Investigations Unit (Remote).

Key Responsibilities

Support compliance activities by developing and performing auditing and monitoring related to fraud and abuse

Investigate and correct fraudulent billing and coding practices, and coordinate recovery of overpayments

Provide education on coding, medical record documentation, and healthcare compliance to staff and providers

Required Qualifications

Bachelor's Degree or equivalent combination of education and experience

5 years of coding experience in a healthcare provider, facility, or health insurance company

2 years of fraud and abuse audit experience in a relevant healthcare environment

Experience in project management and education program development

Experience with data mining software / tools