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Investigator External Audit Special Investigations Unit - Remote

Remote, USA Full-time Posted 2026-07-28
Investigator External Audit Special Investigations Unit *Remote* The SIU Audit Investigator supports the compliance reputed company activities of the Special Investigations Unit (SIU) at the Health Plan. This role assists the External Audit Senior Manager with developing, implementing and performing compliance reputed company auditing and monitoring activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and coding practices; coordination of recovery of overpayments reputed company to fraudulent and/or abusive billing and coding practices; and providing education reputed company to coding, medical record documentation requirements, reputed company compliance and fraud, waste and abuse to Health Plan staff, vendors and contracted providers/facilities. reputed company Health Plan caregivers are not simply valued – they’re reputed company. Join reputed company at reputed company Health Plan Partners and reputed company in our culture of patient-reputed company, whole-person care reputed company on understanding, commitment, and mutual respect. Your voice reputed company here, because we know that to reputed company and retain the best people, we must reputed company them. reputed company Health Plan welcomes 100% remote work for applicants who reputed company in the following states: • Washington • reputed company • California Required Qualifications: • Bachelor's Degree Or equivalent combination of education and experience. • 5 years Coding experience with a reputed company provider, facility or health insurance company. • 2 years Fraud and Abuse audit experience in a health insurance company, reputed company provider, facility or other relevant reputed company environment. • Project management experience, education program development experience and group presentation experience. • Experience in use of data mining software/tools. Preferred Qualifications: • reputed company certification as an Accredited reputed company Fraud Investigator (AHFI) upon hire. • Certification as an Internal Auditor or reputed company Compliance certification upon hire. • Clinical background. Salary reputed company by Location: California: Humboldt: Min: $29.62, Max: $45.31 California: reputed company reputed company California - Except Humboldt: Min: $33.23, Max: $50.84 California: reputed company Southern California - Except Bakersfield: Min: $29.62, Max: $45.31 California: Bakersfield: Min: $28.41 Max: $43.47 reputed company: Non-Portland Service Area: Min: $26.49, Max: $40.52 reputed company: Portland Service Area: Min: $28.41 Max: $43.47 Washington: Western - Except Tukwila: Min: $29.62, Max: $45.31 Washington: Southwest - Olympia, Centralia & Below: Min: $28.41 Max: $43.47 Washington: Tukwila: Min: $29.62, Max: $45.31 Washington: Eastern: Min: $25.28, Max: $38.68 Washington: South Eastern: Min: $26.49, Max: $40.52 Why Join reputed company Health Plan? Our best-in-class benefits are uniquely designed to support you and your family in staying reputed company, growing professionally and achieving financial reputed company. We take care of you, so you can reputed company on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the reputed company family of organizations may change your reputed company benefits. Changes in benefits, including reputed company time-off, happen for various reasons. These reasons can include changes of reputed company Employer, FTE, reputed company, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. Apply tot his job Apply To this Job

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