Payment Integrity Investigator - Must Reside in Colorado
Denver Health Lean Academy(2 months ago)
About this role
The Payment Integrity Investigator at Denver Health Medical Plan conducts investigations into alleged fraud, waste, and abuse within the managed care environment. The role supports DHMP’s FWA prevention and detection program, collaborating across departments and preparing investigative reports and referrals. This position requires residency in Colorado and sits within the Managed Care Administration.
Required Skills
- Fraud Detection
- Data Mining
- Data Analysis
- Medical Coding
- Medical Terminology
- Excel
- Microsoft Office
- Provider Audits
- Report Writing
- Field Work
+2 more
Qualifications
- Bachelor's Degree
- High School Diploma
- GED
- CPC (AAPC)
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