CPC Certified Coding Investigator

Job Summary

A company is looking for an Investigator, Special Investigative Unit Coding (Remote).

Key Responsibilities

• Re-evaluates medical claims and records for accuracy and compliance with regulations
• Manages caseloads and documents to ensure timely investigations and adherence to policies
• Completes medical reviews to support referrals to law enforcement or payment recovery

Required Qualifications

• At least 2 years of CPT coding experience in a relevant setting
• Certification as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar
• Knowledge of medical terminology, billing codes, and healthcare delivery systems
• Experience in fraud, waste, and abuse investigations may be required based on location
• Proficiency in Microsoft Office, especially Excel, and relevant software programs