Remote SIU Investigator & Coding Specialist

Healthcare Fraud Shield; Chesterfield (MO); On-site; USD 42,000 - 70,000; Full time

Benefits offered by this job

401(k) with employer match

Vacation and sick paid time off

7 paid holidays

Paid maternity/paternity leave

Disability & Life insurance

Flexible Spending Account (FSA)

Employee Assistance Program (EAP)

Professional and career development

Job summary

Healthcare Fraud Shield is seeking a CPC-certified Medical Coding Specialist to join our SIU team. You will review medical records, abstract CPT/HCPCS/Revenue Codes, DRG and ICD-9/ICD-10, and determine appropriate billing and reimbursement while maintaining privacy standards.

You will document findings in spreadsheets, summarize them in reports, and provide subject matter expertise for clients. Remote work eligible; 401(k), generous PTO, and professional development opportunities are offered.

Qualifications

• Knowledge of medical terminology.
• Knowledge of CPT, HCPCS, Revenue Codes, DRG Codes, and ICD-10.
• Knowledge of specialty medical practices.
• Must be detail-oriented.
• Ability to communicate effectively both verbally and in writing.
• Respect for privacy and security standards.

Responsibilities

• Work with SIU Team (Clinical Reviewers, CPCs, Investigators, Analysts) to assist coding determinations.
• Analyze and interpret patient medical records for FWA investigations.
• Abstract CPT, HCPCS, Revenue Codes, DRG codes, and ICD-9/ICD-10 from records.
• Document findings in spreadsheets and summarize them in reports.
• Maintain current knowledge of coding guidelines and regulations.
• Perform data analysis of client data as needed.
• Conduct various aspects of FWA investigations as needed.

Skills

Medical terminology

CPT & HCPCS coding

DrG/ICD coding

Attention to detail

Written communication

Discretion and privacy

Goal oriented

Education

Certified Professional Coder (CPC)

Job description

Healthcare Fraud Shield is seeking a CPC-certified Medical Coding Specialist to join our SIU team. You will review medical records, abstract CPT/HCPCS/Revenue Codes, DRG and ICD-9/ICD-10, and determine appropriate billing and reimbursement while maintaining privacy standards.

You will document findings in spreadsheets, summarize them in reports, and provide subject matter expertise for clients. Remote work eligible; 401(k), generous PTO, and professional development opportunities are offered.