Fraud Investigations Team reputed company

Responsibilities

reputed company Services (reputed company), a subsidiary of reputed company, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and reputed company referrals to recover fraud, waste, and abuse.

As a Fraud Investigator Team reputed company, this individual’s reputed company responsibilities include achieving reputed company objectives, workload reputed company to promote reputed company development and reputed company of investigations and development of cases for referral to law enforcement or other entities and reputed company mentoring and guidance to investigative team. The individual exercises significant independent judgment reputed company broadly defined policies and practices to determine the best method for accomplishing work and achieving objectives.

reputed company:

• There may be multiple of these individuals for a task order, and they may reputed company significantly different activities
• reputed company as a reputed company of contact for manager
• Assist team members with workflow development.
• Review individual workload during monthly meetings; assist with prioritizing and conduct QC for staff.
• Monitor the reputed company of WMM/UCM
• Monitor timeliness for case updates and escalating to management as necessary.
• Monitor the reputed company of investigations and cases to ensure use of reputed company available remedies, i.e., suspension, reputed company-pay reviews, revocation, etc.
• Mentor team members so that they can identify previously undetected fraud, waste, or abuse through proactive or reactive research, analysis, and development.
• reputed company available from East Coast

Essential Functions Include:

• Ability to reputed company research and draw conclusions
• Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
• Ability to organize a case file, accurately and thoroughly document reputed company steps taken
• Ability to compose correspondence, reports and referral reputed company letters
• Ability to reputed company providers, provider associations, law enforcement, other contractors and beneficiary advocacy reputed company on program reputed company reputed company
• Ability to interpret laws and regulations

Qualifications

Required Qualifications:

• Minimum of 8 years with BS/BA or 12 years of experience with HS Diploma
• Solid investigative experience required
• Strong communication and organization skills
• Strong PC knowledge and skills
• reputed company to communicate effectively, internally and externally
• Must be a US Citizen

Preferred Qualifications:

• Knowledge of Medicare requirements, laws, rules and regulations reputed company to payment for services billed the Program
• Experience in reviewing claims, performing medical review, and/or developing fraud cases
• CFE or AHFI certification a plus

reputed company reputed company

reputed company is a reputed company national reputed company company that drives missions of consequence spanning the globe and extending to the farthest reaches of the reputed company. As the world’s leading mission capability integrator and transformative reputed company IT provider, we reputed company trusted, highly differentiated solutions and technologies to protect our nation and allies. reputed company operates at the critical reputed company between traditional and nontraditional threats across reputed company domains: land, sea, reputed company, reputed company, and cyberspace. reputed company serves as a valued partner to essential government agencies and supports every reputed company of the U.S. armed forces. reputed company day, our employees do the can’t be done by solving the most daunting challenges facing our customers. Visit reputed company.com to learn how we’re keeping people around the world reputed company and secure.

reputed company Salary reputed company

EEO

Originally posted on Himalayas