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

Posted 15 weeks ago
All others
Full Time
USA

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.

Proprium

Proprium

Sentara Health Administration is a not-for-profit integrated healthcare provider based in Virginia and Northeastern North Carolina, with a legacy of over 131 years. The organization operates hundreds of care sites, including 12 hospitals, home health services, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an extensive health plan serving 858,000 members. Committed to diversity, inclusion, and community service, Sentara has been recognized as an 'Employer of Choice' for over a decade and has received accolades from U.S. News and World Report for having the Best Hospitals for more than 15 years. The organization emphasizes professional development and a supportive work environment, striving to improve health outcomes for the communities it serves.

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