Date Posted
Category
Salary
Job type
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Level
Location
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CotivitiSee more

addressAddressRemote
type Form of workFull-time
salary Salary$60,000 - $80,000 a year
CategoryHealthcare

Job description

Overview:
As a Dental Investigator, you will identify and investigate suspected incidents of dental healthcare fraud, waste or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role. This position may be worked remotely from home anywhere in the US.
Responsibilities:
  • Identify, investigate, analyze and evaluate instances of potential Dental fraud, waste and abuse.
  • Conduct interviews or correspond with patients, providers, witnesses or other relevant parties to determine settlement, denial or review.
  • Analyze information gathered by investigation and report findings and recommendations as a written summary and/or presentation.
  • Conducts investigation-related training.
  • Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions.
  • Negotiates settlement agreements to resolve disputes.
  • Maintain current knowledge of relevant laws, regulations and standards.
  • Participates in special projects as required.
Qualifications:
  • Bachelor’s Degree in related discipline, or the equivalent combination of education, professional training and work experience.
  • 5-8 years of related investigative experience specifically related to dental investigations.
  • 2-3 years of investigative proactive lead generation experience specifically for dental investigations.
  • Advanced level skills in Excel.
  • Excellent verbal and written communication skills.
  • Strong listening and observation skills.
  • Attention to detail and high level of accuracy.
  • Effective organizational and prioritization skills with multi-tasking ability
  • Preferred certifications:
    • Accredited Healthcare Fraud Investigator (AHFI),
    • Certified Fraud Specialist (CFS),
    • Certified Fraud Examiner (CFE),
    • Certified Forensic Interviewer (CFI), or
    • Certified in Healthcare Compliance (CHC).
Base compensation ranges from $60,000 to $80,000. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 1/10/2024
Applications are assessed on a rolling basis. We anticipate that the application window will close on 3/10/2024, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.
#senior
#LI-JB1
#LI-Remote

Benefits

Disability insurance, Health insurance, Dental insurance, 401(k), Paid time off, Family leave, Vision insurance, Life insurance
Refer code: 8202067. Cotiviti - The previous day - 2024-02-11 15:31

Cotiviti

Remote
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