Healthcare Fraud Investigator

1 week ago

Tampa, Florida, United States CenterWell Home Health Full time
Join Our Compassionate Team and Prioritize Health
The Healthcare Fraud Investigator plays a crucial role in examining claims of fraudulent and abusive practices within the healthcare system. This position involves diverse responsibilities that often require independent judgment and the ability to navigate complex situations.

The investigator collaborates with law enforcement agencies to gather evidence and documentation necessary for effective resolution of cases. Responsibilities include conducting thorough audits of provider records to ensure compliance with billing standards and preparing detailed investigative reports. A solid understanding of departmental strategies and operational goals is essential, as well as the ability to make informed decisions with minimal supervision. Adherence to established protocols is expected.


Utilize Your Expertise to Drive Change

Essential Qualifications

  • Extensive clinical experience across various practice areas
  • Minimum of 2 years in healthcare fraud investigation and auditing
  • Familiarity with healthcare payment systems
  • Excellent organizational, interpersonal, and communication abilities
  • Analytical mindset with a strong ability to interpret data
  • Proficient in computer applications (MS Word, Excel, Access)
  • High ethical standards in both personal and professional conduct
  • Commitment to enhancing consumer experiences within the organization

Preferred Qualifications

  • Advanced degree or relevant certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI)
  • Bachelor's degree
  • Insight into the healthcare sector, claims processing, and investigative methodologies
  • Experience in a corporate setting with a grasp of business operations

Additional Information - Our Commitment to You
Comprehensive benefits from day one of employment
Competitive 401k matching
Generous Paid Time Off policy
Tuition assistance programs
Parental leave
Wellness perks through Go365

Remote Work Requirements

To work from home, candidates must have a reliable high-speed DSL or cable internet connection. Employees residing in specific states may receive reimbursement for internet expenses.
A minimum internet speed of 25x10 (25mbps download x 10mbps upload) is required.
Satellite and wireless internet services are not permitted for this role.
A dedicated workspace free from interruptions is necessary to protect sensitive information.

Interview Process
Our hiring process incorporates innovative interviewing technology from a third-party vendor, enhancing our recruitment strategy.

Selected candidates will receive an invitation to participate in a pre-recorded voice interview or an SMS text interview. The voice interview will involve responding to a series of questions via phone, taking approximately 10-15 minutes.

The SMS text interview will consist of a series of questions answered through a mobile device or computer, lasting about 5-10 minutes. Your responses will be reviewed to determine progression to the next interview stage.

Scheduled Weekly Hours

40

Compensation Overview

The salary range provided reflects a good faith estimate for full-time employment. Actual compensation may vary based on location, skills, experience, and education.

Benefits Overview

CenterWell Home Health offers a comprehensive benefits package that promotes overall well-being. Our benefits are designed to support your health and wellness needs while recognizing the importance of work-life balance. We provide medical, dental, and vision coverage, a 401(k) retirement plan, paid time off, and various other benefits.
About Us
CenterWell Home Health is dedicated to prioritizing health for our employees, clients, and communities. Through our healthcare services, we strive to simplify the process for those we serve, ensuring they receive the necessary care and support for optimal health outcomes.

Equal Opportunity Employer

CenterWell Home Health is committed to a policy of equal employment opportunity, ensuring that all individuals are treated fairly without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status. We actively promote diversity and inclusion in our workforce.

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