CPC Certified SIU Investigator

Job Summary

Working remotely in a full-time capacity, the CPC Certified SIU Investigator will analyze patient medical records, determine billing appropriateness, and collaborate with the SIU team to support fraud investigations and coding accuracy.

Key Responsibilities

• Collaborate with the SIU team to perform quality checks, assist in research, and make coding determinations
• Analyze patient medical records and compare them to submitted claims to assess billing accuracy
• Document findings and summarize reports related to fraud investigations and coding compliance

Required Qualifications

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