Managing strategic fraud, waste, and abuse activities, the full-time Fraud and Abuse Manager will develop and implement compliance initiatives while leading teams to investigate referrals and monitor billing processes remotely. Key responsibilities Monitor business processes to ensure integrity and compliance in billing and claims payment Lead teams of analysts in investigating fraud, waste, and abuse referrals Develop and present educational materials and customized fraud plans to meet contract and federal requirements Required qualifications Bachelor's degree in Business, Healthcare, Criminal Justice, or a related field, or equivalent experience 4+ years of experience in medical claim investigation, compliance, or fraud and abuse Thorough knowledge of medical terminology Previous experience in a managed care environment, preferably in a lead or supervisory role Medical records or coding license preferred
Fraud and Abuse Manager in workfromhome at Unknown Company
This position is listed as contract and able to be worked remotely.