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CareOregon

Making health care work for everyone.

Senior Investigator, Investigations Unit

InvestigatorGeneralFull TimeRemoteSeniorTeam 501-1,000Since 1994H1B SponsorCompany SiteLinkedIn

Location

Oregon + 1 moreAll locations: Oregon | Washington

Posted

74 days ago

Salary

$92.1K - $112.5K / year

Seniority

Senior

Bachelor Degree5 yrs expExperience acceptedEnglish

Job Description

Senior Investigator, Investigations Unit

CareOregon

• Administer the fraud, waste, and abuse (FWA) duties at an advanced level • Ensure effective measures are in place and operating effectively to prevent, detect, and correct fraud, waste, and abuse • Perform advanced level of fraud investigations and provide regular FWA reporting to regulatory agencies • Help ensure that appropriate procedures are in place and followed consistently to safeguard assets, verify accuracy and reliability of data, and promote efficient operations • Contribute to the development and operation of an effective FWA program in accordance with CMS requirements and Federal Sentencing Guidelines • Prepare reports of audit findings and recommendations • Educate and coach leaders and staff regarding FWA requirements and complex issues • Participate in completing required Medicare and Medicaid filings and/or responses for FWA

Job Requirements

  • Minimum 5 years’ experience in compliance and/or audit
  • Minimum 1 year experience focused on fraud, waste, and abuse
  • CPC (Certified Professional Coder) or RHIT (Registered Health Information Technician) or CFE (Certified Fraud Examiner) Preferred
  • Fraud, waste and abuse experience in Medicaid or Medicare

Benefits

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • AD&D insurance
  • Disability insurance
  • Health savings account
  • Flexible spending account(s)
  • Lifestyle spending account
  • Employee assistance program
  • Wellness program
  • Discounts
  • Multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
  • Strong retirement plan with employer contributions
  • Paid time off (PTO)
  • Paid State Sick Time
  • Paid holidays
  • Volunteer time
  • Jury duty
  • Bereavement leave

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