Contract: Baltimore, Maryland, US
Salary: $35.00 Per Hour
Job Code: 348524
End Date: 2024-05-19
Days Left: 15 days, 9 hours left
Description :•Initiate claim adjustments, voucher deducts, and voluntary refunds in order to recover funds. Record recoveries and savings following established processes.•Perform special projects as assigned by management to meet the needs of the Special Investigations Unit.•The role of the Special Investigations Unit (SIU) Investigator is to assist in the reduction and recuperation of losses through the detection, investigation, and resolution of low to medium levels fraud, waste, and abuse schemes, resulting in the savings and recovery of fundsQualifications•Bachelor's Degree•2 years insurance, investigative, health care, nursing or law enforcement.•Credential in a health care or investigations related area such as Certified Fraud Examiner (CFE), Accredited Health Fraud Investigator (AHFI), RN/LPN, or Certified Professional Coder (CPC).•Knowledge of ICD 10 and CPT® Codes, medical terminology, extensive training in claims and subscriber customer service methods, and previous experience in the health care industry.
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