Healthcare Fraud Investigator

2 days ago

Hyderabad, Telangana, India beBeeCoding Full time ₹ 10,00,000 - ₹ 15,00,000
Medical Coding Professional

Key Responsibilities:

  • Review patient medical records to identify incorrectly coded services and diagnoses.
  • Develop and maintain a program to prevent fraud, waste, and abuse in the healthcare system.
  • Conduct audits to identify potential cases of fraud, waste, and abuse perpetrated by healthcare providers, facilities, pharmacies, groups, and employees.
  • Investigate special projects, potential cases of fraud, waste, and abuse, conducting initial investigations and coordinating recovery/savings of money related to these issues.

Essential Requirements:

  • 7-9 years of relevant work experience in a medical setting.
  • Medical degree (MBBS, BHMS, BAMS, BUMS) or equivalent with clinical exposure and knowledge of Anatomy, Physiology, and disease processes.
  • Certified Medical Coder with a valid certification from AAPC or AHIMA.
  • Familiarity with coding basics, guidelines, policy guidelines from payors, and coding references.

What We Offer:
Opportunities for career growth and development in a dynamic and challenging environment. A competitive salary package that reflects your skills and qualifications.

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