SIU Investigator - Kansas, United States - Healthcare Fraud Shield

Description

**This position requires residency in Kansas**

Healthcare Fraud Shield, a leading company in healthcare fraud prevention and payment integrity solutions, is seeking a skilled Coder or Clinical Coder/Fraud Investigator to join their team.

RESPONSIBILITIES

• Collaborate with the SIU Team (Clinical Reviewers, CPCs, Investigators, Analysts) for performing quality checks, assisting in research, and making appropriate coding determinations
• Analyze and interpret patient medical records related to FWA investigations
• Determine the appropriateness of billing and reimbursement
• Document findings for each claim line and summarize them in a written report
• Maintain current knowledge of coding guidelines and relevant regulations
• Conduct data analysis and lead generation
• Provide Subject Matter Expertise and SIU support to clients
• Comply with Privacy and Security standards
• Perform various aspects of FWA investigations
• Other duties as assigned

KNOWLEDGE, SKILLS, & ABILITIES

• Proficiency in medical terminology, coding (CPT, HCPCS, DRG Codes), and specialty medical practices
• Detail-oriented with strong communication skills
• Ability to meet defined performance and production goals
• Strong computer skills
• Experience with confidential information management

CERTIFICATE/LICENSE

• Certified Professional Coder (CPC) through AAPC or equivalent certification
• Minimum of one year of coding and/or billing experience

BENEFITS

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

REMOTE WORK REQUIREMENTS

• High-speed Internet connection with a minimum speed of 25mbs download and 5mbs upload is necessary

Healthcare Fraud Shield is an inclusive employer dedicated to diversity. All qualified applicants will be considered without regard to various characteristics as outlined by law.