Ohio Licensed SIU RN Investigator
A company is looking for an Investigator, SIU RN.
Key Responsibilities
Perform medical record audits to verify service documentation and coding accuracy
Conduct interviews with providers and health plan members to investigate potential fraud, waste, or abuse
Generate detailed audit reports and provide education on appropriate coding practices
Required Qualifications
Graduate from an Accredited School of Nursing
Five years of clinical nursing experience with broad clinical knowledge
Five years of experience in medical review and coding/billing audits
Active, unrestricted State Registered Nursing (RN) license in good standing
Knowledge of medical terminology and coding requirements (CPT, ICD-9, HCPCS, DRG)
A company is looking for an Investigator, SIU RN.
Key Responsibilities
Perform medical record audits to verify service documentation and coding accuracy
Conduct interviews with providers and health plan members to investigate potential fraud, waste, or abuse
Generate detailed audit reports and provide education on appropriate coding practices
Required Qualifications
Graduate from an Accredited School of Nursing
Five years of clinical nursing experience with broad clinical knowledge
Five years of experience in medical review and coding/billing audits
Active, unrestricted State Registered Nursing (RN) license in good standing
Knowledge of medical terminology and coding requirements (CPT, ICD-9, HCPCS, DRG)