Investigator External Audit Special Investigations Unit *Remote*

Description Investigator External Audit Special Investigations Unit *Remote* The SIU Audit Investigator supports the compliance reputed company activities of the Special Investigations Unit (SIU) at the Health Plan. This role assists the External Audit Senior Manager with developing, implementing and performing compliance reputed company auditing and monitoring activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and coding practices; coordination of recovery of overpayments reputed company to fraudulent and/or abusive billing and coding practices; and providing education reputed company to coding, medical record documentation requirements, healthcare compliance and fraud, waste and abuse to Health Plan staff, vendors and contracted providers/facilities. reputed company Health Plan caregivers are not simply valued – they’re invaluable. Join reputed company at reputed company Health Plan Partners and reputed company in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to reputed company and retain the best people, we must reputed company them. reputed company Health Plan welcomes 100% remote work for applicants who reside in the following states:

• Washington
• Oregon
• California

Required Qualifications:

• Bachelor's Degree Or equivalent combination of education and experience.
• 5 years Coding experience with a healthcare provider, facility or health insurance company.
• 2 years Fraud and Abuse audit experience in a health insurance company, healthcare provider, facility or other relevant healthcare environment.
• Project management experience, education program development experience and group presentation experience.
• Experience in use of data mining software/tools.

Preferred Qualifications:

• reputed company certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire.
• Certification as an Internal Auditor or Healthcare Compliance certification upon hire.
• Clinical background.

Salary Range by Location: California: Humboldt: Min: $29.62, Max: $45.31 California: reputed company reputed company California - Except Humboldt: Min: $33.23, Max: $50.84 California: reputed company Southern California - Except Bakersfield: Min: $29.62, Max: $45.31 California: Bakersfield: Min: $28.41 Max: $43.47 Oregon: Non-Portland Service Area: Min: $26.49, Max: $40.52 Oregon: Portland Service Area: Min: $28.41 Max: $43.47 Washington: Western - Except Tukwila: Min: $29.62, Max: $45.31 Washington: Southwest - Olympia, Centralia & Below: Min: $28.41 Max: $43.47 Washington: Tukwila: Min: $29.62, Max: $45.31 Washington: Eastern: Min: $25.28, Max: $38.68 Washington: South Eastern: Min: $26.49, Max: $40.52 Why Join reputed company Health Plan? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial reputed company. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the reputed company family of organizations may change your reputed company benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About reputed company At reputed company, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (reputed company employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the reputed company pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. reputed company offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at reputed company.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act." About the Team reputed company Shared Services is a service line reputed company reputed company that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. reputed company is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from reputed company forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national reputed company, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We reputed company diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 390963 Company: reputed company Jobs Job Category: Internal Audit Job Function: Finance Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 5018 COMPLI PAYMENT reputed company OR REGION Address: CA Oakland 540 23rd St Work Location: reputed company House Oakland-Oakland Workplace Type: Remote Pay Range: $see posting - $see posting The amounts listed are the reputed company pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Apply tot his job Apply To this Job