Overview:
Responsibilities:
Base compensation ranges from $64,500 to $85,000. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
#senior
As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse (FWA) through
data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role. This position may be worked remotely from home anywhere in the US.
Responsibilities:
- Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse.
- Conduct interviews or correspond with patients, providers, witnesses or other relevant parties to determine settlement, denial or review.
- Analyze information gathered by investigation and report findings and recommendations as a written summary and/or presentation.
- Conducts investigation-related training.
- Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions.
- Negotiates settlement agreements to resolve disputes.
- Maintain current knowledge of relevant laws, regulations and standards.
- Participates in special projects as required.
- Bachelor’s Degree in related discipline, or the equivalent combination of education, professional training and work experience.
- 5-8 years of related investigative experience.
- Advanced level skills in Excel.
- Excellent verbal and written communication skills.
- Strong listening and observation skills.
- Attention to detail and high level of accuracy.
- Effective organizational and prioritization skills with multi-tasking ability
- Preferred certifications:
- Accredited Healthcare Fraud Investigator (AHFI),
- Certified Fraud Specialist (CFS),
- Certified Fraud Examiner (CFE),
- Certified Forensic Interviewer (CFI), or
- Certified in Healthcare Compliance (CHC).
Job Demands:
- This is a work-at-home position. Access to high-speed internet is required (all other equipment will be provided).
- Must be able to sit and use a computer keyboard for extended periods of time
- Travel up to 15%
- Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones.
- After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent)
Base compensation ranges from $64,500 to $85,000. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
#senior
#LI-JB1
#LI-Remote
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