California Licensed Audit Investigator

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

Key Responsibilities

Support compliance activities by developing and performing auditing and monitoring related to fraudulent billing and coding practices

Coordinate recovery of overpayments due to fraudulent billing and provide education on healthcare compliance

Assist the External Audit Senior Manager in compliance-related investigations and corrective actions

Required Qualifications

Bachelor's Degree or equivalent combination of education and experience

5 years of coding experience with 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

Familiarity with data mining software / tools