Certified Professional Coder (CPC), or willingness to obtain within 12 months from hire date 5+ years of experience in the health insurance industry; in auditing, claims processing, payment integrity, claims configuration 2+ years of experience conducting or managing comprehensive research to identify billing abnormalities, questionable billing practices, irregularities, and fraudulent or abusive billing activity 2+ years of experience using claims platforms such as UNET, Pulse, NICE, Facets, Diamond, etc