Cotiviti · 3 weeks ago
Senior Investigator (Healthcare FWA)
United States
Full-time
Remote
Mid, Senior Level
$70K/yr - $90K/yr
5+ years expCotiviti is a company focused on combating fraud, waste, and abuse in healthcare. As a Senior Investigator, you will investigate suspected incidents of healthcare fraud through data analysis, conduct interviews, report findings, and support legal proceedings as necessary.
Information Technology & Services
Responsibilities
Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse
Conduct interviews or correspond with patients, providers, witnesses or other relevant parties to determine settlement, denial or review
Analyze information gathered by investigation and report findings and recommendations as a written summary and/or presentation
Conducts investigation-related training
Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions
Negotiates settlement agreements to resolve disputes
Maintain current knowledge of relevant laws, regulations and standards
Participates in special projects as required
Qualification
Required
Bachelor's Degree in related discipline, or the equivalent combination of education, professional training and work experience
5-8 years of related investigative experience
Advanced level skills in Excel
Excellent verbal and written communication skills
Strong listening and observation skills
Attention to detail and high level of accuracy
Effective organizational and prioritization skills with multi-tasking ability
Access to high-speed internet is required (all other equipment will be provided)
Must be able to sit and use a computer keyboard for extended periods of time
Travel up to 15%
Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones
After hours and/or weekend work is required where necessary for major deliverables/deadlines (not consistent)
Communicating with others to exchange information
Assessing the accuracy, neatness, and thoroughness of the work assigned
Remaining in a stationary position, often standing or sitting for prolonged periods
Repeating motions that may include the wrists, hands, and/or fingers
Must be able to provide a dedicated, secure work area
Must be able to provide high-speed internet access/connectivity and office setup and maintenance
Preferred
Accredited Healthcare Fraud Investigator (AHFI)
Certified Fraud Specialist (CFS)
Certified Fraud Examiner (CFE)
Certified Forensic Interviewer (CFI)
Certified in Healthcare Compliance (CHC)
Benefits
Medical
Dental
Vision
Disability
Life insurance coverage
401(k) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.
Company
Cotiviti
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Adam Gilbert
Director, Interoperability Operations and Partnerships
Chris McIntyre
Sr. Program Manager, RQNC Operations
Recent News
2024-04-07
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