Senior Investigator - Remote in New York - UnitedHealth Group : Job Details

Conduct confidential investigations and audits, document relevant findings and report any illegal activities in accordance with all laws and regulations Detect and investigate discrepancies, errors, or inconsistencies within medical records, coding, billing practices or documentation Review claims, look for patterns of potential fraud, waste and/or abuse and interact with medical providers to request medical records for investigations Investigate provider coding accuracy, billing practices and adherence to both UHC policy and government regulations The challenge for you will be the high volume of cases on your plate at one time. You will be part of a team responsible for triaging, investigating and resolving instances of healthcare fraud and/or abusive conduct. You will spend your time doing audits, claims data analysis, conducting investigations and putting together your findings Youll be rewarded and recognized for your performance in an environment that will challenge you and give y...Investigator, Healthcare, Processing, Remote, Senior, Technology, Fraud