Investigator External Audit Special Investigations Unit *Remote*

Lensa; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare provider is seeking an Investigator for the External Audit Special Investigations Unit. This remote role involves supporting compliance activities and conducting audits to ensure adherence to regulations. Candidates should have significant experience in healthcare coding and auditing, along with strong project management skills. Join a team committed to patient-focused care and enjoy comprehensive benefits.

Benefits

401(k) plan

Health insurance

Life and disability coverage

Paid leave

Comprehensive benefits

Qualifications

• 5 years of coding experience with a healthcare provider, facility, or health insurance company.
• 2 years of fraud and abuse audit experience in a healthcare environment.
• Current certification as a CPC is preferred.

Responsibilities

• Support compliance activities of the Special Investigations Unit (SIU).
• Assist the External Audit Senior Manager with compliance-related auditing.
• Implement and perform monitoring activities.

Skills

Project management

Education program development

Group presentation

Data mining

Education

Bachelor's Degree or equivalent experience

Tools

Data mining software/tools

Job description

Investigator External Audit Special Investigations Unit *Remote*

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Description

Investigator External Audit Special Investigations Unit (SIU) Remote.

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

Providence Health Plan values its caregivers and fosters a culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, and we aim to empower our team members.

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

• Washington
• Oregon
• California

Required Qualifications

• Bachelor's Degree or equivalent 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 healthcare environment.
• Project management, education program development, and group presentation experience.
• Experience with data mining software/tools.

Preferred Qualifications

• Current certification as a CPC.
• Certifications such as AHFI, CHC, or CIA.
• Clinical background is preferred.

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 support your well-being, professional growth, and financial security. We care for our employees so they can focus on delivering our mission of caring for everyone, especially the vulnerable.

Note: Benefits may change when transitioning between facilities within Providence due to various factors.

About Providence

We are committed to our promise of “Know me, care for me, ease my way,” providing inclusive, respectful workplaces with a rich history of serving communities across multiple states. Our caregivers serve in hospitals, clinics, and social services, continuing a tradition of over 100 years of service.

Additional compensation may include shift differentials, on-call pay, overtime, bonuses, etc. Providence offers comprehensive benefits including a 401(k) plan, health insurance, life and disability coverage, paid leave, and more. Learn more at providence.jobs/benefits.

About The Team

Providence Shared Services supports our mission by providing system support and specialized expertise across our organization. We are dedicated to fostering an inclusive, diverse workforce where everyone’s contributions are valued.

Providence is an Equal Opportunity Employer, committed to diversity and inclusion.

Requisition ID: 363730

Job Category: Internal Audit

Job Function: Finance

Employment Type: Full-time

Workplace Type: Remote