State Licensed Clinical Investigator

Job Summary

A company is looking for a Clinical Investigator I (Special Investigation Unit).

Key Responsibilities

• Audit medical records to identify inappropriate billing practices and recommend next steps
• Investigate and analyze provider billing patterns to ensure compliance with regulations
• Prepare summaries of findings and recommend preventative measures for future practices

Required Qualifications, Training, and Education

• Associate's Degree in a related field or equivalent experience preferred
• 2+ years of related clinical experience in the field
• Coding certification from an accredited organization required
• Relevant licenses such as RN, LPN, or related certifications required