Nurse Investigator
Employment type
Full-time
Work setting
On-site
Location
Charleston, WV
Schedule
Day shift
Posted
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Job overview
The Nurse Investigator is an onsite role based in Charleston, WV. Compensation is not specified in the posting, and the role supports The Health Plan of West Virginia's Special Investigations Unit. This role exists to detect and investigate healthcare fraud, waste, and abuse. It contributes to the company's goals by conducting medical chart reviews and billing audits to ensure program integrity.
What you'll do
- Conduct investigations, analyze claims data, perform medical record reviews, and prepare findings for regulatory agencies.
What we're looking for
- Skills & competencies
- full-timeonsitecharleston wvnurse investigatorhealthcarefraud investigationcompliancemedical auditingrnthe health plan
- Work arrangement
- Weekend coverage required
Benefits & perks
- Competitive salary, professional development.
Why this role
Requires RN license and coding certification; experience with Medicaid/Medicare preferred.
About the employer
The Health Plan of West Virginia Inc is hiring for this role. Industry: Claims Adjusting. Sector: 52.
Additional details
- Industry sector
- 52
- Industry
- Claims Adjusting
- Occupation code
- 29-1141.00
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Listing ID: 36f3ed8e-134c-45f9-9894-81c7896f025d