What are the responsibilities and job description for the Florida Licensed Fraud Investigator position at VirtualVocations?
A company is looking for a Principal Fraud & Abuse Investigator.Key ResponsibilitiesConduct in-depth investigations for suspected fraud or abuse involving various stakeholdersReview quality of coding through desk and on-site audits, ensuring adherence to health plan policiesAssist in training staff and developing departmental policies and reporting for compliance with state and federal integrity activitiesRequired QualificationsBachelor's Degree in a related discipline8-10 years of related investigative experience or 5-7 years of healthcare investigative experience with CFE or AHFICertified Professional Coder required (or to be achieved within 12 months of hire)Accredited Health Care Fraud Investigator (AHFI) required (or to be achieved within 24 months of hire)5 years of experience in Coding, Healthcare, Internal / External Audits, and Regulatory Compliance
