SIU Clinical Investigator

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Collaborate with the SIU Team, which includes Clinical Reviewers, CPCs, Investigators, and Analysts; conduct quality checks, assist in research, and engage in discussions regarding appropriate coding determinations.

• Evaluate and interpret patient medical records for FWA investigations.

• Compare claim details to ascertain the nature and amount of billable services.

• Assess the appropriateness of billing and reimbursement.

• Record findings for each claim line in a spreadsheet.

• Compile findings into written reports.

• Extract CPT, HCPCS, Revenue Codes, DRG codes, and ICD-9/ICD-10 from medical records.

• Stay up-to-date with coding guidelines and relevant federal and/or state regulations.

• Conduct data analysis on client data.

• Oversee various components of FWA investigations.

• Offer subject matter expertise and SIU support to clients.

• Adhere to company Privacy and Security standards.

• Safeguard and properly manage protected health information.

• Execute other duties as required.

⛳️ Requirements

• Understanding of medical terminology.

• Proficiency in coding, including CPT, HCPCS, Revenue Codes, DRG Codes, and ICD-10.

• Familiarity with specialty medical practices.

• Strong attention to detail.

• Ability to communicate effectively in both verbal and written forms.

• Excellent listening skills.

• Ability to work independently.

• Demonstrated responsibility.

• Self-disciplined.

• Capability to achieve defined performance and production targets.

• Strong computer proficiency.

• Ongoing discretion and secure management of confidential and sensitive information.

• Certified Professional Coder (CPC®) from the AAPC governing body.

• A minimum of one year of coding and/or billing experience is required.

• Must possess high-speed internet with a minimum download speed of 25mbs and upload speed of 5mbs; satellite internet is not permitted.

🏝️ Benefits

• Medical, Dental & Vision insurance.

• 401(k) retirement savings plan with employer matching.

• Paid vacation and sick time off.

• 7 paid holidays and 2 floating holidays.

• Paid maternity and paternity leave.

• Disability and Life insurance.

• Flexible Spending Account (FSA).

• Employee Assistance Program (EAP).

• Opportunities for professional and career development.

• Eligibility for remote work.