Auditor/Investigator I

This is a fully remote position, open to applicants in United States.

📋 Description

• Acts as an entry-level professional responsible for developing foundational plans to ensure the integrity and precision of claims processes and protocols.

• Gathers data for audits and investigations related to claims by employing a mix of analytical skills and meticulous attention to detail.

• Reviews documentation, conducts interviews with involved parties, and engages with various stakeholders to achieve successful claim resolutions.

• Identifies potential opportunities to address fraud, waste, abuse, or discrepancies in claims submissions.

• Analyzes data to evaluate the legitimacy of claims and offers accurate recommendations to management.

• Records and inputs all findings, creating detailed reports for audit and investigative purposes.

⛳️ Requirements

• A minimum of a Bachelor's Degree is required.

• 0 - 2 years of experience is necessary; 2 - 4 years is preferred.

• Certification as a Fraud Examiner or as an Accredited Healthcare Anti-Fraud Investigator is preferred.

🏝️ Benefits

• Competitive salary and comprehensive health benefits.

• Opportunities for professional development and advancement.

• Supportive work environment with a focus on work-life balance.