VirtualVocations
via Talent.com
CPC Certified Fraud Investigator
Compensation
$70K - 90K a year
Responsibilities
Conduct investigations related to healthcare fraud and abuse, review coding quality, and assess referrals.
Requirements
Requires a Bachelor's Degree or 2+ years of relevant experience, CPC certification or within 12 months, and preferably CFE or AHFI certifications.
Full Description
A company is looking for an Associate Fraud and Abuse Investigator. Key Responsibilities Conduct in-depth investigations for suspected fraud or abuse related to various interactions Review coding quality through desk and occasional on-site audits Assess incoming referrals and assist in investigations of potential fraud, waste, and abuse Required Qualifications Bachelor's Degree or a minimum of 2 years of relevant experience in Medical Coding, Healthcare, or related fields Certified Professional Coder (CPC) required, or must achieve within 12 months of hire Preferred certifications include Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) Experience in claims investigations or regulatory / compliance roles is beneficial
This job posting was last updated on 12/12/2025
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