CPC Certified Fraud Investigator

A company is looking for an Associate Fraud and Abuse Investigator.

Key Responsibilities

Conduct in-depth investigations for suspected fraud or abuse related to various interactions

Review coding quality through desk and occasional on-site audits

Assess incoming referrals and assist in investigations of potential fraud, waste, and abuse

Required Qualifications

Bachelor's Degree or a minimum of 2 years of relevant experience in Medical Coding, Healthcare, or related fields

Certified Professional Coder (CPC) required, or must achieve within 12 months of hire

Preferred certifications include Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI)

Experience in claims investigations or regulatory / compliance roles is beneficial