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West Virginia Employer Investigative Intake Coordinator in Wheeling, West Virginia

The SIU Investigative Intake Coordinator (IIC) is part of a team focused on the prevention, detection, investigation, and reporting of healthcare fraud, waste, and abuse FWA, program integrity initiatives, and the recovery of overpayments in a multi-payer environment. The IIC provides critical support services to the unit, by coordinating various functions prior to and during the investigative process which facilitates efficiency of, and ultimately better outcomes for the investigations. The IIC acts as the SIU's Law Enforcement Liaison, utilizing outstanding organizational skills in fulfilling all data requests and analytics for the WV MFCU, the WVOIC, the ODI, the USAO, and other law enforcement or regulatory entities. The IIC is also responsible for screening and triaging incoming complaints and preparing cases for investigator review, statistical tracking, and preparation of internal reporting for other THP Depts. Required: -Associates Degree in any field OR at least 2 years of relevant experience such as: SIU, healthcare fraud investigation, medical claim investigation, healthcare program integrity, data mining or analytics, healthcare claims payment processing, clinical experience, compliance, or certification as AHFI, CPC/CCP/CCS/CMC or CFE. - Proficiency in Microsoft programs. -Strong organizational skills. - Detail Oriented. - Effective oral and written communication skills. - Ability to plan and execute projects independently and meet tight deadlines. -Ability to prioritize tasks. - Holds a Certified Medical Coder certification. Responsibilities: - Entering cases into the case management and tracking system and Analyzing healthcare claims data. - Identify and recommend process improvements to reduce FWA. -Others as determined by supervisor.

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