Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) - Remote

Overview

Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! This is a full-time, permanent position that involves contributing to investigations regarding fraud and abuse in healthcare.

In Short

• Remote position for candidates in specified states.
• Full-time role with a 40-hour workweek.
• Responsibilities include investigating fraud and abuse cases.
• Conduct audits of pharmacy and physician coding.
• Review claims data for suspicious patterns.
• Maintain comprehensive case files.
• Participate in special projects as needed.
• Requires a Bachelor's Degree or relevant experience.
• Must have Certified Professional Coder (CPC) certification.
• Benefits include medical, dental, and tuition assistance.

Requirements

• Bachelor's Degree or 2 years of relevant experience.
• Certified Professional Coder (CPC) required.
• Preferred certifications: CFE or AHFI.
• Strong professional writing and verbal communication skills.
• Proficient in Microsoft Office Suite.
• Ability to manage time effectively and solve complex problems.
• Experience in healthcare, auditing, or investigations.

Benefits

• Medical, Dental, and Vision plans.
• Adoption and fertility reimbursement up to $10,000.
• Paid Time Off and Sick Leave.
• 401k/403B with employer match.
• Tuition assistance up to $5,250/year.
• Student debt pay down of $10,000.
• Reimbursement for certifications and access to CEUs.
• Annual discretionary bonus opportunity.
• Supportive family-friendly culture.
• Diversity and inclusion commitment.