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Investigator
A company is looking for an Investigator to conduct audits and reviews of cases related to coding and billing compliance. Key Responsibilities Conduct detailed audits and reviews of cases to assess compliance with coding, documentation, and billing standards Identify potential instances of fraud, waste, and abuse, and verify charges Generate preliminary and final audit results and collaborate with clients for report delivery and overpayment recovery Required Qualifications Strong auditing, medical record review, and documentation skills Knowledge of coding standards, billing practices, and compliance requirements Experience with data analytics and fraud detection techniques Bachelor's degree in a related field and relevant certifications are a plus Familiarity with HIPAA regulations and corporate integrity agreements
A company is looking for an Investigator to conduct audits and reviews of cases related to coding and billing compliance.
Key Responsibilities
Conduct detailed audits and reviews of cases to assess compliance with coding, documentation, and billing standards
Identify potential instances of fraud, waste, and abuse, and verify charges
Generate preliminary and final audit results and collaborate with clients for report delivery and overpayment recovery
Required Qualifications
Strong auditing, medical record review, and documentation skills
Knowledge of coding standards, billing practices, and compliance requirements
Experience with data analytics and fraud detection techniques
Bachelor's degree in a related field and relevant certifications are a plus
Familiarity with HIPAA regulations and corporate integrity agreements