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Peraton
Peraton
Sponzor vizuma H1BLogistikaSvetovanjeZdravstveno varstvo
Peraton je tehnološko podjetje, osredotočeno na izvajanje pomembnih misij, ki zagotavlja storitve strankam na področju nacionalne varnosti, vojske in državne uprave. Njegovo delo obsega napredne IT- in kibernetske storitve, vključno s kibernetsko obrambo, delovanjem v oblaku, inženiringom, obveščevalnimi dejavnostmi in tehnološkimi rešitvami, ki temeljijo na podatkih. Peraton združuje velike specializirane ekipe za reševanje kompleksnih operativnih in varnostnih izzivov, pri čemer delovna mesta podpirajo zagotavljanje tehnoloških zmogljivosti za kritične misije.
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Delovna mesta v podjetju

Fraud Auditor Associate

Investigate suspected healthcare provider fraud for Peraton’s SafeGuard Services by reviewing medical claims, developing cases, and supporting audits, referrals, and overpayment recovery.

USZdružene države Amerike
39.000 $ – 62.000 $ / leto
Na daljavoPolni delovni časJuniorSrednja ravenDiploma ni potrebnaZahtevani Jezik: angleščinaRevizor

Opis

  • Conduct entry-level fraud investigations and audits with direct supervision from a team manager or lead.
  • Investigate medical service providers and prepare cases and reports for law enforcement referrals, education, overpayment recovery, and administrative action.
  • Coordinate with internal teams, external agencies, state and federal investigators, and other personnel on cases, audits, and corrective actions.
  • Manage several caseloads at once and organize and analyze information.
  • Help prepare complex reports that apply rules or regulations to affected programs.
  • Research relevant offenses and carry out efficient investigations and audits.
  • Identify or verify suspected violations through observation, records review, and interviews.
  • Assess investigation and audit findings to determine whether allegations are supported and what corrective steps are appropriate.
  • Draft correspondence that is objective and accurate.
  • Protect confidential health information and follow applicable laws, rules, and regulations.
  • Maintain case files and document investigative and audit work.
  • Write correspondence, reports, and referral summary letters.
  • Educate providers, provider associations, law enforcement, contractors, and beneficiary advocacy groups about program safeguards.
  • Submit timely reports of work activity.
  • Attend meetings and training conferences; overnight travel may be required.

Zahteve

  • No experience required with a bachelor’s degree, or four years of experience with a high school diploma or equivalent.
  • Investigative and analytical experience.
  • Strong communication and organizational skills.
  • Strong computer skills.
  • U.S. citizenship required.
  • A background in investigations or compliance audits is preferred for the most competitive candidates.
  • Experience reviewing claims for technical requirements, conducting medical reviews, or developing fraud cases and identifying overpayments is preferred for the most competitive candidates.
  • Knowledge of investigative or audit practices involving healthcare providers is preferred for the most competitive candidates.
  • Knowledge of Medicare or Medicaid programs and their rules, regulations, policies, and procedures is preferred for the most competitive candidates.
  • Experience evaluating, reviewing, and analyzing medical claims and records is preferred for the most competitive candidates.
  • Ability to learn and use data systems, equipment, and tools used in investigations.
  • Ability to research information and draw conclusions.
  • Ability to interpret laws and regulations.
  • Ability to handle confidential material.
  • Ability to work as a team member under direct supervision.
  • Ability to attend meetings and training conferences; overnight travel may be required.

Ugodnosti

  • Telework is available from the Eastern Time Zone.
  • Overtime eligibility may apply.
  • Shift differentials may apply.
  • A discretionary bonus may apply.
  • Equal opportunity employment, including for people with disabilities and protected veterans.

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