Job Description:
• Assist and support the SIU team with daily tasks
• Help with intake and triage of client-assigned tasks
• Assist in analyzing patient medical records for fraud, waste, and abuse investigations
• Support comparison of medical records with claim information to determine billable services
• Document findings for each claim line in a spreadsheet
• Contribute to written reports summarizing findings
• Assist with abstracting CPT, HCPCS, Revenue Codes, DRG codes, and ICD-9/ICD-10 from medical records
• Support maintaining current knowledge of coding guidelines and regulations
• Assist with client data analysis
• Provide basic support for various aspects of fraud, waste, and abuse investigations
• Comply with and follow company Privacy and Security standards
• Respect and protect confidential and sensitive information, including protected health information
• Perform other duties as assigned
Requirements:
• Basic knowledge of medical terminology
• Basic knowledge of coding concepts, including CPT, HCPCS, and ICD-10
• Basic knowledge of specialty medical practices
• Attention to detail
• Ability to communicate clearly and effectively, both verbally and in writing
• Good listening skills
• Ability to work both independently and as part of a team
• Responsible and self-disciplined
• Ability to meet defined performance and production goals
• Basic computer skills
• Discretion and secure information management when accessing confidential and sensitive information, including protected health information
• No specific investigative experience is required; healthcare knowledge and a strong interest in medical claims, coding, and investigations is a plus
• High-speed internet with minimum 25mbs download and 5mbs upload; satellite internet is not allowed
Benefits:
• Medical, Dental & Vision insurance
• 401(k) retirement savings with employer match
• Vacation and sick paid time off
• 7 paid holidays & 2 floating holidays
• Paid maternity/paternity leave
• Disability & Life insurance
• Flexible Spending Account (FSA)
• Employee Assistance Program (EAP)
• Professional and career development initiatives
• Remote work eligible
• High speed Internet required with a minimum speed of 25mbs download and 5mbs upload; satellite is not allowed