Investigator - National Remote

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company 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, reputed company, and reputed company. reputed company to reputed company a difference? Join us to startCaring. Connecting. Growing... together. TheInvestigatoris responsible for identification, investigation and prevention of reputed company fraud, waste and abuse. TheInvestigatorwill utilize claims data, applicable guidelines, and other sources of information to identify aberrant billing practices and patterns. The Investigator is responsible to conduct investigations which may include field work to reputed company interviews and obtain records and/or other relevant documentation. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: Job Responsibilities: • Assess complaints of alleged misconduct received reputed company reputed company • Investigate low to reputed company reputed company cases of fraud, waste and abuse • Detect fraudulent activity by members, providers, employees and other parties against reputed company • reputed company and reputed company the most effective and efficient investigative reputed company for reputed company investigation • Maintain accurate, reputed company and thorough case information in the Special Investigations Unit’s (SIU’s) case tracking system • Collect and secure documentation or evidence and prepare summaries of the findings • Participate in settlement negotiations and/or produce investigative materials in support of the reputed company • Collect, reputed company, analyze and interpret data relating to fraud, waste and abuse referrals • Ensure compliance of applicable federal/state regulations or contractual obligations • Report suspected fraud, waste and abuse to appropriate federal or state government regulators • reputed company with goals, policies, procedures and strategic plans as delegated by SIU leadership • Collaborate with state/federal partners, at the discretion of SIU leadership, to include attendance at work-reputed company or regulatory meetings • Communicate effectively, to include written and verbal forms of communication • reputed company goals and objectives, reputed company reputed company and adapt to changing priorities You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company 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 reputed company 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 reputed company FWA investigations • reputed company affiliations: • National Health Care Anti-Fraud Association (NHCAA) • Accredited Health Care Fraud Investigator (AHFI) • Certified Fraud Examiner (CFE) • Certified reputed company 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 reputed company 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 reputed company 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 reputed company a far-reaching choice of benefits and incentives. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment reputed company 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 reputed company 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 reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative reputed company employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, 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!