Remote SIU Investigator: Healthcare Coding & Fraud

Healthcare Fraud Shield; Chesterfield (MO); Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

401(k) retirement savings with employer match

Paid time off (vacation and sick)

Paid holidays & floating holidays

Paid maternity/paternity leave

Disability & Life insurance

Flexible Spending Account (FSA)

Employee Assistance Program (EAP)

Professional and career development initiatives

Job summary

A leading company in healthcare fraud prevention is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical records, documenting findings, and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a minimum of one year of coding experience. Join a dedicated team committed to preventing healthcare fraud and ensuring payment integrity.

Qualifications

• Must have knowledge of medical coding guidelines.
• Requires access to confidential and sensitive information.
• Experience in healthcare fraud investigations is a plus.

Responsibilities

• Analyze and interpret patient medical records for fraud investigations.
• Document findings in spreadsheets and reports.
• Perform data analysis related to healthcare fraud.

Skills

Knowledge of medical terminology

Knowledge of coding (CPT, HCPCS, Revenue Codes, DRG Codes, ICD-10)

Detail oriented

Effective verbal and written communication

Ability to meet performance goals

Education

Certified Professional Coder - (CPC) through governing body AAPC or equivalent certification

Minimum of one year coding and/or billing experience

Job description

A leading company in healthcare fraud prevention is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical records, documenting findings, and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a minimum of one year of coding experience. Join a dedicated team committed to preventing healthcare fraud and ensuring payment integrity.