California Licensed Audit Investigator

Job Summary

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

Key Responsibilities

• Support compliance activities of the Special Investigations Unit by developing and performing auditing and monitoring activities
• Identify, investigate, and correct fraudulent and abusive billing and coding practices
• 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 with a healthcare provider, facility, or health insurance company
• 2 years of fraud and abuse audit experience in a relevant healthcare environment
• Project management and education program development experience
• Experience in the use of data mining software/tools