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Urgent! FWA Investigator Coder Sr. Associate (Remote) Job Opening In Boston – Now Hiring Commonwealth Care Alliance
Why This Role is Important to Us
Position Summary:
The FWA Investigator Coder Sr. Associate is an integral part of the Fraud, Waste & Abuse (FWA) Special Investigation Unit (SIU).
The position reports directly to the Sr. Director, Fraud, Waste & Abuse.
This position utilizes a variety of FWA investigative tools and techniques to complete activities required to identify compliance with state and federal results, regulations, and requirements.
This position is responsible for completing a variety of program integrity reviews and activities within their required timeframes.
This role requires effective communication with providers, and other CCA departments related to review processes and results.
Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and applies FWA tools to create, maintain and summarize review findings that are timely, accurate and well documented.
This position is responsible for conducting analysis to identify trends related to potentially inappropriate submission of claims by providers and collaborates with other team members and areas in making recommendations for payment integrity.
This may include making recommendations for Payment policies, system enhancements, and prepay edits.
The FWA Sr. Investigator Coder will be proficient at each step of the review process including internal/external communication, medical record documentation review, application of regulations and identification of submitted codes not supported by medical record documentation.
Supervision Exercised:
No, this position does not have direct reports.
What You'll Be Doing
Essential Duties & Responsibilities:
Working Conditions:
✨ Smart • Intelligent • Private • Secure
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Unlock Your FWA Investigator Potential: Insight & Career Growth Guide
Real-time FWA Investigator Jobs Trends in Boston, United States (Graphical Representation)
Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph below. This graph displays the job market trends for FWA Investigator in Boston, United States using a bar chart to represent the number of jobs available and a trend line to illustrate the trend over time. Specifically, the graph shows 2250 jobs in United States and 32 jobs in Boston. This comprehensive analysis highlights market share and opportunities for professionals in FWA Investigator roles. These dynamic trends provide a better understanding of the job market landscape in these regions.
Great news! Commonwealth Care Alliance is currently hiring and seeking a FWA Investigator Coder Sr. Associate (Remote) to join their team. Feel free to download the job details.
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An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at Commonwealth Care Alliance adheres to the cultural norms as outlined by Expertini.
The fundamental ethical values are:The average salary range for a FWA Investigator Coder Sr. Associate (Remote) Jobs United States varies, but the pay scale is rated "Standard" in Boston. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.
Key qualifications for FWA Investigator Coder Sr. Associate (Remote) typically include Business Operations Specialists and a list of qualifications and expertise as mentioned in the job specification. Be sure to check the specific job listing for detailed requirements and qualifications.
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Before the Interview:To prepare for your FWA Investigator Coder Sr. Associate (Remote) interview at Commonwealth Care Alliance, research the company, understand the job requirements, and practice common interview questions.
Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the Commonwealth Care Alliance's products or services and be prepared to discuss how you can contribute to their success.
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