Presbyterian Healthcare Services

Investigator III-ABQ

Presbyterian Healthcare Services

2 months ago
Remote
Full Time
Senior
0 applicants
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Presbyterian Healthcare Services
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About this role

An Investigator III at Presbyterian Health Plan operates within the Program Integrity / Special Investigations Unit focused on detecting and preventing healthcare fraud, waste, and abuse across the health plan. This is a full-time, remote position based in New Mexico that supports Medicaid, Medicare, Marketplace, and commercial lines of business. The role requires relevant healthcare experience and industry certifications in coding or fraud investigation.

Skills

Qualifications

Bachelors DegreeCertified Professional Coder (CPC)Certified Professional Medical Auditor (CPMA) - PreferredCertified Fraud Examiner (CFE) - PreferredAccredited Health Care Fraud Investigator (AHFI) - Preferred
Presbyterian Healthcare Services

About Presbyterian Healthcare Services

phs.org

Find the medical care and health plan you and your family need at Presbyterian Healthcare Services, an integrated system of hospitals, healthcare providers and insurance plans serving patients and members in New Mexico.

About Presbyterian Healthcare Services

Headquarters

San Francisco, CA

Company Size

201-500 employees

Founded

2018

Industry

Technology

Glassdoor Rating

4.2 / 5

Leadership Team

Sarah Johnson

Chief Executive Officer

Michael Chen

Chief Technology Officer

Emily Williams

VP of Engineering

David Rodriguez

VP of Product

Jessica Thompson

Chief Financial Officer

Andrew Park

VP of Sales

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