CPC Certified Fraud Investigator
virtual vocationsDenver, CO
CPC Certified Fraud Investigator
L5
virtual vocationsDenver, COtoday
Occupations
Fraud Examiners, Investigators and AnalystsClaims Adjusters, Examiners, and InvestigatorsCompliance OfficersIndustries
All Other Insurance Related ActivitiesInvestigation and Personal Background Check ServicesPharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsContributing to in-depth investigations of suspected fraud and abuse, the full-time remote Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) will assess leads, review coding practices, and maintain case files while ensuring compliance with health insurance policies.
Key responsibilities:
Conduct investigations into potential fraud, waste, and abuse across various interactions
Review quality of coding through desk audits and occasional on-site audits
Maintain comprehensive case files and participate in special projects as required
Required qualifications:
Bachelor's Degree or minimum of 2 years of relevant experience in Medical Coding, Healthcare, or related fields
Certified Professional Coder (CPC) certification required (or to be achieved within 12 months of hire)
Preferred certifications include Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI)
Experience in claims investigations, regulatory compliance, or internal/external auditing is essential
Apply now (opens in a new tab)
Level
SeniorL5
Location
Denver, CO
Occupation
Fraud Examiners, Investigators and Analysts
Industry
All Other Insurance Related Activities
Posted
today
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