Data Entry Question and Answer

$150 $49

Remote Question and Answer

$150 $49

Virtual Assistant Question and Answer

$150 $49

Content Moderator Question and Answer

$150 $49

Customer Service Question and Answer

$150 $49

Video Game Tester Question and Answer

$150 $49

Healthcare Fraud Investigator at Integrity Advantage (Remote)

Other Jobs To Apply

Levels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications.

Integrity Advantage is a small woman owned business serving health payers and other entities challenged with the detection, investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and looking for dynamic, confident and skilled individuals who want to grow with us. Our current need is a healthcare FWA investigator to assist our clients in identifying potential allegations of fraud, conducting investigations and assisting in the recovery process. This is a client facing position, so phenomenal customer service skills are key to being hired for this position.

Essential daily duties and responsibilities:

  • Perform timely, thorough and well documented investigations

  • Maintain, organize and prioritize leads and investigations of varying complexity

  • Gather evidence, research and other information to substantiate or refute allegations

  • Utilize clients fraud detection solution to identify post-payment or pre-payment opportunities for investigation as well as other applications to perform data mining or track investigative results

  • Support multiple clients with Medicaid, Medicare, Federal Employee and Commercial lines of business

  • Communicate status updates to clients as appropriate

  • Prepare well written investigative reports including any findings from medical record reviews

  • Knowledgeable in using RAT-STATS for statistically valid random sampling

  • Ability to provide support to clients for law enforcement referrals, settlement or legal proceedings

  • Support other initiatives, as required

Required Education / Licenses / Certifications:

  • Bachelors degree

  • Accredited Healthcare Fraud Investigator (AHFI) preferred

Experience:

  • At least 2 years of healthcare claims investigation experience

Knowledge, Skills & Abilities:

  • Integrity, accountability and confidence

  • Demonstrated ability to create solutions to problems

  • Ability to travel for training events, conferences and provide onsite assistance to clients, when needed (appropriate notice will be provided)

  • Excellent grasp of MS Word, Excel and PowerPoint

  • Quickly adapt to different anti-fraud technology solutions including ad-hoc query, analytical and case management applications

  • Knowledge of federal and state guidelines as well as ICD, CPT, HCPCS, DRG, and rev codes

  • Ability to demonstrate professionalism as well as written and oral communication skills

  • Ability to work independently within a remote team, under minimal supervision

Benefits:

  • 401(k)

  • Dental insurance

  • Health insurance

  • Paid time off

  • Professional development assistance

  • Vision insurance

Education:

  • Bachelor's Degree

License/Certification:

  • AHFI or CFE or other industry certification


Remote

Skills:
Case Management, Communication Skills, Conferences, Current Procedural Terminology (CPT), Customer Relations, Customer Support/Service, Data Mining, Diagnosis-Related Group (DRG), Establish Priorities, Fraud Investigation, Healthcare, Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD), Investigative Reports, Law Enforcement, Litigation Settlement, Medicaid, Medical Records, Medicare, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Presentation/Verbal Skills, Query Analysis, Small Business, Statistical Sampling, Time Management, Vision Plan, Willing to Travel, Writing Skills


About the Company:
HireAligned



Back to blog

Yelp Question and Answer

$150 $49

Amzon Question and Answer

$150 $49

Netflix Question and Answer

$150 $49

Disney Question and Answer

$150 $49

Apple Question and Answer

$150 $49

Southwest Airline Q & A

$150 $49

Delta Airline Q & A

$150 $49

Costco Question and Answer

$150 $49

American Question and Answer

$150 $49

Walmart Question and Answer

$150 $49

Tesla Question and Answer

$150 $49

Google Question and Answer

$150 $49

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...