SIU Coding Investigator New Jersey New York

Job Summary

An employer is seeking a Coding SIU Investigator for a remote position.

Key Responsibilities:

• Investigate and resolve instances of healthcare fraud and abuse by medical providers
• Review post pay claims and medical records to determine accuracy of claims payments
• Complete medical review to facilitate referral to law enforcement or payment recovery

Required Qualifications:

• High School Diploma / GED (or higher)
• 3+ years CPT coding experience or 5+ years of experience in FWA/SIU or Fraud investigations role
• Thorough knowledge of PC based software including Microsoft Word and Excel
• Licensed registered nurse (RN), licensed practical nurse (LPN), and/or certified coder (CPC, CCS, and/or CPMA)
• Bachelor's degree (or higher) preferred