| Provider Billing Investigator II Job Description |
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| The following is a full job description for Provider Billing Investigator II. Here are the requirements and responsibilities for Provider Billing Investigator II along with statistics. If after reading this page you determine that Provider Billing Investigator II is not the position you are looking for, you may want to try one of these similar titles: Provider Billing Investigator I, Provider Billing Investigator III, Billing Analyst II, Billing Clerk II, Provider Billing Senior Auditor, Provider Billing Auditor, Provider Billing Investigation Manager, Billing Supervisor, Billing Manager |
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| Requirements and Responsibilities For Provider Billing Investigator II |
| Responsible for investigating and auditing healthcare providers to detect and prevent medical billing fraud, waste, and abuse. Reviews medical billing and insurance claims to identify billing anomalies, outliers, and patterns of upcoding, phantom billing, or duplicate charges. Compiles evidence and documents findings in investigative reports. Refers cases of fraud to law enforcement or state regulatory agencies. Requires a bachelor's degree. Typically reports to a manager. Occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. Typically requires 2-4 years of related experience. |
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| Also referred to as: Provider Billing & Fraud Investigator II |
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| Similar Jobs: Provider Billing Investigator I, Provider Billing Investigator III, Billing Analyst II, Billing Clerk II, Provider Billing Senior Auditor, Provider Billing Auditor, Provider Billing Investigation Manager, Billing Supervisor, Billing Manager |
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| Level of Education: Provider Billing Investigator II Salaries with No Diploma, Provider Billing Investigator II Salaries with a High School Diploma or Technical Certificate, Provider Billing Investigator II Salaries with an Associate's Degree, Provider Billing Investigator II Salaries with a Bachelor's Degree, Provider Billing Investigator II Salaries with a Master's Degree or MBA, Provider Billing Investigator II Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Business Services, Edu., Gov't. & Nonprofit, Financial Services, Healthcare, Insurance | |
