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SIU Investigator

Employer
PrimeWest Health
Location
Alexandria, MN
Salary
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Industry
Professional Services
Role
Other
Job Type
Long-Term
Hours
Full Time

Job Details

This position is responsible for a range of compliance, auditing, and monitoring activities. The SIU Investigator will assist with PrimeWest Health's efforts to ensure compliance with laws, regulations, and policies that govern its Medicare Parts C and D and Medicaid business lines. This individual will initiate investigations and develop cases for future action. This includes referring cases to law enforcement and regulatory authorities, providing education, preventing and recovering overpayment, and performing other administrative actions. The SIU Investigator works with internal resources and external agencies to develop cases and corrective actions as well as respond to requests for data and support.

Educational Requirements and Required Qualifications
At minimum, experience in health care FWA investigations, encounter data analysis, medical record auditing, provider profiling, and/or claims preparation or examination with a health plan or other health care entity, regulatory agency, government program, and/or internal audit or fraud unit is required. A bachelor's degree in business or other related field is preferred; however, equivalent additional experience in a compliance-related function or medical coding will be considered in lieu of a degree.

PrimeWest Health will accept resumes for this position until filled. No phone inquiries please. Employment to begin as soon as possible.

Click on apply to email your resume - Please include SIU Investigator in the subject line or mail resume & cover letter to

Attn: Rebecca Fuller, Corporate Compliance/HIPAA Privacy Officer
PrimeWest Health
3905 Dakota St
Alexandria, MN 56308

EOE

Company

Located in Alexandria, MN, we are a partnership of greater Minnesota counties that have joined together to find innovative solutions to meet the health care needs of our communities.

We’re glad you’re thinking about a career at PrimeWest Health. We pride ourselves on being a customer-centered health plan committed to excellence, innovation, and, above all, providing the best possible services and programs for our health plan members. And all this starts with our most valued and important resource—our employees.

PrimeWest Health is always looking for ways to improve our organization through hiring, developing, and retaining motivated employees to maintain that professional yet personal touch that connects us with our customers and to one another—and that separates us from other health plans. This means that a career with PrimeWest Health offers more than just a paycheck. (But yes, we do also provide paychecks.)

Company info
Website
Location
Alexandria
Minnesota
56308
United States

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