2024-09-19
Molina Healthcare (https://careers.molinahealthcare.com/)
Other
/yr
full-time
employee
United States
JOB DESCRIPTION
Job Summary
The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely turn around. This position ensures adherence to state and federal policies, CPT guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or for payment recovery.
KNOWLEDGE/SKILLS/ABILITIES
JOB QUALIFICATIONS
Required Education
High School Diploma / GED (or higher)
Required Experience
Required License, Certification, Association
Certified Coder (CPC, CCS, and/or CPMA)
Preferred Education
Bachelor's degree (or higher)
Preferred Experience
Preferred License, Certification, Association
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $19.64 - $42.55 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.