Ncqa Jobs in Oregon (NOW HIRING)

Company Overview:

Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.

JOB DESCRIPTION: 

Allied Universal Compliance and Investigations is seeking candidates to fill the role of the Field Site Inspector. The Field Site Inspector will perform site visit inspection services for Medicare and Medicaid providers/suppliers in accordance with established requirements. The Inspector works independently to visit assigned locations, take photographs, conduct interviews, collect data, and document findings.  Inspections must be completed using approved guidelines and standards.  

• Must possess a valid driver's license with at least one year of driving experience   

• Pay Rate: $23 - $28 / hr   

RESPONSIBILITIES: 

• Conduct independent investigations of assigned cases in a specific geographic area. 

• Document and report observations, activities, and any relevant information in a clear and concise manner using mobile devices (tablets and cell phones) 

• Maintain confidentiality and adhere to legal and ethical standards with the highest professional standards while conducting site inspections 

• Efficient and timely workload management to meet assignment time completion. 

• Review and verify credentials, including education, training, licensure, and certification, for healthcare providers and healthcare facilities as required.  

• Ensure that healthcare providers meet all necessary qualifications and requirements as detailed on provider/supplier-specific site visit checklist forms. 

• Collaborate with Desktop Inspectors and other PEO SVS operational staff for the execution and reporting of site visit inspection performance.  

• Professional attire, demeanor, and Interaction during all contacts with provider/suppliers/facility administrative staff/representative throughout the entire site inspection process.  

QUALIFICATIONS (MUST HAVE): 

• High school diploma or equivalent 

• Proficient in utilizing laptop computers, mobile devices, and tablets.  

• Flexibility to work varied and irregular hours/days including weekends 

• Successful completion of the Allied Universal Investigations' training/orientation course  

• Successful completion of all required Site Inspector training, internal and CMS-required, both initial and in-service training.  

PREFERRED QUALIFICATIONS (NICE TO HAVE): 

• Associate degree or higher, preferably in Criminal Justice 

• Prior insurance investigations and/or healthcare facility on-site inspections/compliance. 

• Knowledge of Regulations: Familiarity with industry regulations, such as those from the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC), Medicare Provider Enrollment, or other healthcare profession or facility credentialing, is highly preferred. 

• Effective public speaking and communication skills. 

BENEFITS:  

• Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance 

• Seven paid holidays annually, sick days available where required by law 

• Vacation time offered at an initial accrual rate of 3.08 hours biweekly. Unused vacation is only paid out where required by law. 

Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com

If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.