Healthcare Fraud Investigator jobs in United States
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HealthCare Support · 23 hours ago

Healthcare Fraud Investigator

HealthCare Support is a respected health plan organization that provides Medicare and Medi-Cal healthcare services to over 1.5 million members in Rancho Cucamonga, California. They are seeking a Healthcare Fraud Investigator to oversee daily revenue cycle operations, ensure compliance in coding and billing accuracy, and manage a team of billing staff and vendors.

DatabaseHealth Care
Hiring Manager
Melanie Williams
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Responsibilities

Assign oversight to daily revenue cycle operations including billing, AR, denials, and appeals
Review coding and billing accuracy to ensure compliance and proper reimbursement
Oversee a team of billing/RCM staff 4-5 and vendors

Qualification

Fraud investigationsMedi-Cal knowledgeMedicare knowledgeFederal reportingState reportingTeam oversightBilling accuracyRevenue cycle operations

Required

Bachelor's degree from an accredited institution required
6+ years relevant professional experience in fraud, waste, and abuse investigations, including Federal and State reporting requirements
Experience working directly with a health plan, with full knowledge of Medi-Cal and Medicare

Benefits

Very low healthcare premiums ($35 – $100 depending on the plan!)
3 ½ weeks of PTO (18 days) & 11 Paid Holidays
Fitness Reimbursement up to $125/a year and on-site fitness facility
Tuition reimbursement after 1 year of employment
457(b) Retirement Plan – matches 3% of base salary
CalPERS Retirement Plan (i.e., pension plan for all employees) – full vesting after 5 years

Company

HealthCare Support

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HealthCare Support is a national niche recruitment firm that has a singular focus - placing top talent in the dynamic healthcare industry.

Funding

Current Stage
Growth Stage
Total Funding
unknown
2021-11-29Acquired
2016-10-01Non Equity Assistance

Leadership Team

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Clay Coleman
Chief Operating Officer
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Company data provided by crunchbase