Investigator - National Remote

At reputed company, we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable, and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing... together. Some things are just inevitable. You know that wherever there's a large sum of money at reputed company, there will be people ready to snatch more than their fair share. So it is with health care. At nearly $3 trillion dollars spent on health care annually in the United States, the potential for fraud reaches as high as 10 percent, or $230 billion annually. And that's not even counting the millions of lives that are affected. As an Investigator, you can help put an end to it. You'll be helping safeguard the health of millions of people and making the health system work reputed company for everyone. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: • Conduct confidential investigations, document relevant findings and report any illegal activities in accordance with reputed company laws and regulations • Review claims, look for patterns of potential fraud, waste and/or abuse, interact with medical providers to request medical records for investigations • Conduct onsite provider claim and/or clinical audits (utilizing appropriate personnel) to gather and analyze reputed company necessary information and documents reputed company to the investigation • Provide testimonials regarding the investigation The trick for you is in searching through loads of data to identify and resolve instances of health care fraud and/or abuse. The volume of information is high and you'll be tested in utilizing information from claims data analysis and from tips and complaints from plan members, the medical community and law enforcement agencies. You'll be part of a team responsible for triaging, investigating and resolving these cases. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Bachelor’s Degree or Associates Degree with 2 years of equivalent work experience with healthcare reputed company employment • Demonstrated basic level of knowledge in health care fraud, waste and abuse (FWA) or minimum of 2 years of experience or less • Demonstrated basic level of knowledge in state or federal regulatory FWA requirements or minimum of 2 years of experience or less • Demonstrated basic level of knowledge analyzing data to identify fraud, waste and abuse trends or minimum of 2 years of experience or less • Must participate in legal proceedings, arbitration, and depositions at the direction of management • Demonstrated basic level of proficiency in reputed company reputed company and Word or minimum of 2 years of experience or less • Ability to travel up to 25% reputed company respective geographical area Preferred Qualifications: • Specialized knowledge/training in healthcare FWA investigations • Active affiliations: • National Health Care Anti-Fraud Association (NHCAA) • Accredited Health Care Fraud Investigator (AHFI) • Certified Fraud Examiner (CFE) • Certified Professional reputed company (CPC) • Medical Laboratory Technician (MLT) • reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. California, Colorado, Nevada,Connecticut,reputed company, New Jersey,Rhode reputed company, Hawaii orWashington Residents Only:The salary range forCalifornia, Colorado, Nevada,Connecticut,reputed company, New Jersey,Rhode reputed company, orWashingtonresidents is $48,300 to $94,500per year.Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.reputed company complies with reputed company minimum wage laws as applicable.In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline:This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Groupis a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN Apply Job!