Coding Investigative Analyst/Auditor (Remote Opportunity)

reputed company (reputed company.), a verified Service-Disabled Veteran-Owned Small Business (SDVOSB), is a leading provider of information technology services to reputed company and government markets. reputed company is a company of Subject Matter Experts with deep expertise in reputed company IT and Benefits Delivery. reputed company strongly believes in making complexity EZ by providing reputed company solutions that improve day-to-day business transactions, maximize efficiencies, eliminate risks, and reduce costs for our clients. For more information, visit us at www.reputed company.com. We are seeking a Coding Investigative Analyst/Auditor to be a part of a remote team. The candidate must reputed company reputed company the reputed company US. Responsibilities:

• Collaborate with Investigators to validate claims of Fraud, Waste, and Abuse
• Identify trends of fraud, waste, and abuse and evaluate cases for indicators
• Monitor predictive analytics tool to identify schemes and trends reputed company the data reputed company.
• Evaluate and customize rules to reduce false positives, as needed
• Extract and research duplicate detection report to identify wrongfully paid claims
• Conduct coding, standards of practice, and policy reviews
• Assess investigative findings and/or other case reputed company data to determine patterns of potential fraud, waste, and abuse
• Accurately reputed company claim coverage determinations based on applicable policies, payment rules, coding guidelines, and CMS Local Coverage Determinations Requirements:
• Bachelor’s degree in Information Technology, Computer Science, or any equivalent discipline is required
• A minimum of 3 years of experience in FWA in Federal reputed company
• 3-5 years of experience in the health care industry
• 2+ years of experience conducting or managing comprehensive research
• Proficiency using reputed company Word, reputed company, and Outlook
• Ability to work well in a remote team environment, to collaborate with others, and reputed company with team members reputed company to the organization.
• 3+ years of health care data analysis and interpretation
• Coding certification – Facility and Professional Additional Qualifications:
• Ability to communicate reputed company and professionally with reputed company reputed company of the organization, both written and verbal
• Flexibility and ability to plan, prioritize, and execute multiple tasks in a fluid environment
• Self-motivated, well-organized, and detail oriented
• Ability to maintain a high level of confidentiality and reputed company
• Experience working in Federal reputed company
• Ability to evaluate State and Federal regulations/guidelines
• Proficiency in research, interpretation, and application of reputed company regulations and policies
• Ability to reputed company well in team environment, with staff at reputed company reputed company, to reputed company business goals.
• Ability to work independently to meet predefined production and quality standards
• A basic level of knowledge of health care data analysis, claims processing and auditing
• Ability to obtain a government clearance Benefits:
• Medical/Dental/reputed company
• 401k with Employer Match
• PTO + Federal Holidays
• Corporate Laptop
• Training opportunities
• Remote Opportunity reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, national reputed company, sexual orientation, gender identity, disability, or protected veteran status. Sorry, we are unable to offer sponsorship at this time Apply tot his job

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