Investigator External Audit Special Investigations Unit *Remote*

Providence Health & Services; Portland (OR); Remote; USD 65,000 - 95,000; Full time

Job summary

An innovative healthcare organization seeks a dedicated Audit Investigator to join their Special Investigations Unit. This role offers the opportunity to support compliance activities and conduct audits within a patient-focused environment. As part of a dynamic team, you will leverage your expertise in coding and fraud audits to ensure the integrity of healthcare practices. Enjoy the flexibility of 100% remote work while contributing to a mission-driven organization that values your voice and empowers you to make a difference in the community. If you're passionate about compliance and healthcare, this position is perfect for you.

Benefits

Best-in-class benefits

Professional growth opportunities

Financial security support

Qualifications

• 5 years of coding experience with a healthcare provider or health insurance company.
• 2 years of fraud and abuse audit experience in a relevant healthcare environment.

Responsibilities

• Support compliance activities within the Special Investigations Unit (SIU).
• Assist in developing and performing compliance-related audits.

Skills

Coding experience

Fraud and abuse audit experience

Project management

Education program development

Data mining software/tools

Education

Bachelor's Degree or equivalent

Tools

Data mining software

Job description

Investigator External Audit - Special Investigations Unit (SIU) (Remote)

The SIU Audit Investigator supports compliance activities within the Special Investigations Unit (SIU) at the Health Plan. This role assists the External Audit Senior Manager in developing, implementing, and performing compliance-related audits and monitoring activities.

About Providence Health Plan

Providence Health Plan caregivers are invaluable. Join our team and thrive in a culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters, as we believe empowering our staff inspires and retains the best talent.

Remote Work Eligibility

Providence Health Plan offers 100% remote work for applicants residing in:

• Washington
• Oregon
• California

Required Qualifications

• Bachelor's Degree or equivalent education and experience
• 5 years of coding experience with a healthcare provider, facility, or health insurance company
• 2 years of fraud and abuse audit experience in a relevant healthcare environment
• Project management, education program development, and group presentation experience
• Experience with data mining software/tools

Preferred Qualifications

• Current certification as a CPC
• Certification as an Internal Auditor or Healthcare Compliance upon hire
• Certifications such as AHFI, CHC, or CIA
• Clinical background

Salary Range by Location

Details vary by state and region, with specific minimum and maximum hourly rates listed for California, Oregon, and Washington areas.

Why Join Providence Health Plan?

Our best-in-class benefits are designed to support your well-being, professional growth, and financial security. We focus on caring for everyone, especially the most vulnerable in our communities.