CPC Certified Clinical Investigator

Job Summary

To support the SIU team, the full-time remote CPC Certified Clinical Investigator will analyze patient medical records, perform quality checks, and document findings related to fraud, waste, and abuse investigations.

Key Responsibilities

• Collaborate with the SIU team to conduct quality checks and assist in coding determinations
• Analyze patient medical records and claims to assess billing appropriateness and reimbursement
• Document findings and summarize results in written reports for FWA investigations

Required Qualifications

• Certified Professional Coder (CPC) certification through AAPC
• Minimum of one year of coding and/or billing experience
• Knowledge of CPT, HCPCS, Revenue Codes, DRG Codes, and ICD-10
• Familiarity with medical terminology and specialty medical practices
• Strong computer skills and ability to manage confidential information securely