Job ID: 52707
Location: Linthicum Heights, MD
Category: Research, Professional Services
Experience: 1 to 2 years
Education: See Requirements
ABOUT THE POSITION
We are currently seeking a dynamic Fraud & Abuse Investigator II to join our team at our office in Linthicum, Maryland. The Fraud & Abuse Investigator will be responsible for conducting pre-payment, post payment and routine provider audits.
Education: Master’s licensed clinician or nurse with 1-2 years of experience required.
Licensure: Maryland licensed; Graduate level or higher; if graduate level licensure 1-2 years’ experience required (LGSW, LCSW, LCSW-C, LGPC, LCPC, LCADC, LGADC)
Relevant Work Experience: Minimum of 3 years’ experience in healthcare, nursing, accounting, law enforcement or healthcare coding and auditing, with at least 1-2 years QI or clinical experience including knowledge of clinical treatment, quality improvement procedures, state requirement or managed care, preference given to candidates with this experience in a managed care environment. 1-2 years’ experience with healthcare fraud and abuse investigations preferred.
Knowledge, Skills & Abilities:
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Beacon Health Options company is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled