Making health care work for everyone.
Senior Investigator, Investigations Unit
Location
Oregon + 1 moreAll locations: Oregon | Washington
Posted
74 days ago
Salary
$92.1K - $112.5K / year
Seniority
Senior
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
