Medicaid Claims Auditor & Investigator RN

CoventBridge Integrity Systems; United States; A distancia; USD 70.000 - 110.000; Jornada completa

Descripción de la vacante

CoventBridge Integrity Systems seeks an experienced Medicaid claims auditor with an active RN license to review claims for potential fraud. You will leverage ICD-10-CM/CPT coding knowledge to assess payment accuracy and document investigative findings.

The role involves preparing detailed investigative summaries and providing expert testimony when required. Prior Medicaid experience and strong analytical skills are essential in this on-site position in the United States.

Formación

• Active RN license required.
• 2+ years Medicaid experience.
• 4+ years claims auditing experience.
• Knowledge of ICD-10-CM/CPT coding.

Responsabilidades

• Review claims files to detect potentially fraudulent billing practices.
• Use medical terminology and coding to assess payment appropriateness.
• Write investigative summary reports and provide expert testimony.

Conocimientos

RN license

Medicaid experience

Claims auditing

ICD-10-CM/CPT coding

Descripción del empleo

CoventBridge Integrity Systems seeks an experienced Medicaid claims auditor with an active RN license to review claims for potential fraud. You will leverage ICD-10-CM/CPT coding knowledge to assess payment accuracy and document investigative findings.

The role involves preparing detailed investigative summaries and providing expert testimony when required. Prior Medicaid experience and strong analytical skills are essential in this on-site position in the United States.