Job Description

Healthcare Fraud Investigator – Hybrid!

HealthCare Support is actively seeking a Healthcare Fraud Investigator to join a respected health plan organization, that provides Medicare and Medi-Cal healthcare services to over 1.5 million members in Rancho Cucamonga, California .

Schedule

• Monday – Thursday 8:00 am – 5:00 pm
• Onsite Tuesday – Thursday and remote on Mondays and Fridays

Compensation

• $80,000 – $95,000 annually (depending on experience)
• Annual HEDIS Incentive: Up to 10%
• Annual Merit Increases: Up to 3% based upon individual performance

Benefits

• Very low healthcare premiums ($35 – $100 depending on the plan!)
• 3 ½ weeks of PTO (18 days) & 11 Paid Holidays
• Fitness Reimbursement up to $125/a year and on-site fitness facility
• Tuition reimbursement after 1 year of employment
• 457(b) Retirement Plan – matches 3% of base salary
• CalPERS Retirement Plan (i.e., pension plan for all employees) – full vesting after 5 years

Daily Responsibilities

• Assign oversight to daily revenue cycle operations including billing, AR, denials, and appeals
• Review coding and billing accuracy to ensure compliance and proper reimbursement
• Oversee a team of billing/RCM staff 4-5 and vendors

Qualifications

• Bachelor’s degree from an accredited institution required
• 5+ years relevant professional experience in fraud, waste, and abuse investigations, including Federal and State reporting requirements
• Experience working directly with a health plan , with full knowledge of Medi-Cal and Medicare

Interested in this opportunity?

Click Apply Now for immediate consideration, or reach out to our Recruiter, Melanie Williams with any questions:

• Call: (407) 346-0844
• Email: Melanie.Williams@healthcaresupport.com
• Schedule a Call:

Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Hybrid

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