FRAUD & ABUSE INVESTIGATOR
Bachelor's Level Degree
Required: Related - 3 years
Preferred: Insurance - 3 years
None, unless noted in the “Other” section below
Required: Coding, Complex Problem Solving, Critical Thinking, Microsoft Excel, Microsoft Office, Speaking, Time Management, Writing
Preferred: Microsoft Access
Related experience includes: Coding 3 years OR Healthcare (Medical Chart Review/Insurance Billing) - 3 years OR Internal/External Audit - 3 years OR Regulatory/Compliance - 3 years OR Claims Investigations 3 years OR Criminal Investigation/White Collar Crime 3 years. Certified Professional Coder required (or achieved within 12 months of hire date). Certified Fraud Examiner (CFE) preferred or Accredited Health Care Fraud Investigator (AHFI) preferred.