HealthCare Support · 5 days ago
Healthcare Fraud Investigator
HealthCare Support is a respected health plan organization providing Medicare and Medi-Cal healthcare services to over 1.5 million members. They are seeking a Healthcare Fraud Investigator to oversee daily revenue cycle operations, ensure compliance, and manage a team of billing staff.
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
Required
Bachelor's degree from an accredited institution required
5+ 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
HealthCare Support is a national niche recruitment firm that has a singular focus - placing top talent in the dynamic healthcare industry.