Summary Primarily responsible for reviewing medical and/or behavioral health claims and clinical documentation in relation to investigations of possible fraud, waste or abuse. Verify correct billing and/or coding of ICD-10 and CPT codes of health plan claims according to medical record documentation. Identification of medical record support for global/bundled codes. Prepare a detailed written report of the audit findings and present the findings to the SIU Program Manager and the Compliance Director.Education & Experience
This job listing is no longer active.
Check the left side of the screen for similar opportunities.