SIU Analyst

Healthcare Fraud Shield; Chesterfield (MO); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) match

Paid time off

Paid holidays

Parental leave

Disability insurance

Life insurance

FSA

EAP

Job summary

Healthcare Fraud Shield is seeking a talented SIU Analyst to support the SIU team with daily tasks, intake triage, and analysis of patient medical records for fraud investigations. You will help compare medical records to claim information to determine billable services and document findings in structured reports.

The role requires basic knowledge of CPT/HCPCS/ICD-10, strong attention to detail, and the ability to work independently or as part of a team while protecting confidential information.

Qualifications

• Basic knowledge of medical terminology and coding concepts (CPT, HCPCS, ICD-10).
• Attention to detail and ability to work independently and in a team.
• Clear written and verbal communication; ability to document findings accurately.

Responsibilities

• Assist SIU team with daily tasks and intake/triage of client tasks.
• Analyze patient medical records for fraud, waste, and abuse investigations.
• Compare medical records to claim data to determine billable services.
• Document findings for each claim line and summarize in reports.

Skills

Medical terminology

Coding concepts

Attention to detail

Communication skills

Teamwork

Discretion

Meet performance goals

Basic computer skills

Tools

Spreadsheet software

EMR systems

Job description

SIU Analyst

Department: SIU

Employment Type: Full Time

Location: Headquarters

Description

Healthcare Fraud Shield, a leader in healthcare fraud prevention and payment integrity solutions, is looking for a talented SIU Analyst to join our team.

Key Responsibilities

• Assist and support the SIU team (Managers, Clinical Reviewers, CPCs, Investigators, and Analysts) with daily tasks.
• Help with the intake and triage of client-assigned tasks.
• Assist in the analysis of patient medical records for FWA investigations.
• Support the comparison of medical records to claim information to determine billable services.
• Help with documenting findings for each claim line in a spreadsheet.
• Contribute to summarizing findings in a written report.
• Assist with abstracting CPT, HCPCS, Revenue Codes, DRG codes, and ICD-9/ICD-10 from medical records.
• Support the team in maintaining current knowledge of coding guidelines and regulations.
• Assist with data analysis of client data.
• Provide basic support for various aspects of FWA investigations.
• Comply with all company Privacy and Security standards.
• Understand and follow all company Privacy and Security standards.
• Respect and protect confidential and sensitive information, including protected health information.
• Perform other duties as assigned.

Skills, Knowledge and Expertise

• Basic knowledge of medical terminology.
• Basic knowledge of coding concepts, including CPT, HCPCS, and ICD-10.
• Basic knowledge of specialty medical practices.
• Attention to detail.
• Ability to communicate clearly and effectively, both verbally and in writing.
• Good listening skills.
• Ability to work both independently and as part of a team.
• Responsible and self-disciplined.
• Ability to meet defined performance and production goals.
• Basic computer skills.
• This job requires access to confidential and sensitive information, which means discretion and secure information management are essential.

Certificate/License:

• No specific investigative experience is required, but healthcare knowledge and a strong interest in medical claims, coding, and investigations is a plus.

Benefits

• Medical, Dental & Vision insurance
• 401(k) retirement savings with employer match
• Vacation and sick paid time off
• 7 paid holidays & 2 floating holidays
• Paid maternity/paternity leave
• Disability & Life insurance
• Flexible Spending Account (FSA)
• Employee Assistance Program (EAP)
• Professional and career development initiatives
• Remote work eligible

REMOTE WORK REQUIREMENTS:

• Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.

Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.