SIU Coding Auditor
Oscar
full-time
Posted on:
Location Type: Hybrid
Location: Arizona • Florida • United States
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Salary
💰 $64,832 - $94,546 per year
About the role
- Identify and conduct investigations into suspected FWA with high autonomy
- Document findings to include formal investigative reports, tables, graphs, audit logs, and other supporting documentation
- Met metrics to align with caseload, turn around times, and other unit-wide goals
- Continue to monitor providers with substantiated findings to track behavior change
- Participate in the development and presentation of FWA-related education for Oscar teams
- Build evidentiary files for potential recovery, legal action, and/or referrals to appropriate outside agencies
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- 3+ years of healthcare fraud investigation experience or professional investigation experience with law enforcement agencies
- 3+ year experience with applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity
Benefits
- Employee benefits
- Participation in Oscar's unlimited vacation program
- Annual performance bonuses
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
investigative reportingdata analysisaudit loggingevidentiary file preparationfraud investigationlegal action documentationmetrics trackingbehavior monitoringeducation developmentpresentation skills
Soft Skills
autonomycommunicationorganizational skillsattention to detailcollaboration