Presbyterian Healthcare Services

SIU Field Investigator

Presbyterian Healthcare Services(12 days ago)

OnsiteFull TimeMedior$51,209.6 - $78,166.4Program Integrity
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About this role

The SIU Field Investigator role involves conducting audits and investigations related to healthcare fraud, waste, and abuse. The position requires evaluating provider claims and documentation, interviewing witnesses, and collaborating with government agencies to detect and prevent fraudulent activities. This full-time, exempt role is based in Albuquerque, NM, supporting Presbyterian Health Plan's Program Integrity Department.

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Required Skills

  • Medical Coding
  • Investigations
  • Healthcare Claims
  • Fraud Detection
  • Report Writing
  • Claims Systems
  • Case Management
  • Medical Records
  • Healthcare Regulations
  • Audit
Presbyterian Healthcare Services

About Presbyterian Healthcare Services

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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.

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