Remote Fraud & Prepay Coding Investigator (CPC/CCS)
Colorado Psychiatric
- Remote job
UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and provider abuse using CPT coding guidance. You will mentor investigators, review claims against medical records, and coordinate with internal and external stakeholders to ensure compliant, accurate coding. The role supports telecommuting from anywhere in the United States, with strong benefits, recognition programs, and opportunities for professional growth. #J-18808-Ljbffr Colorado Psychiatric
$70.5k - $94.4k
...Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to... ...documentation to conduct low level investigations. The incumbent will also... ..., receive and review suspected fraud and to complete cases with all...Remote workFraudLive inLocal area$21.82 - $51.06 per hour
...DESCRIPTION Provides support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates... .... Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical...Remote workFraudHourly payContract workWork experience placementWork at officeLocal area- Optum is seeking a Coding Consultant to investigate and resolve healthcare fraud and abuse, using CPT coding knowledge to document findings and guide investigations. The role offers telecommuting from anywhere in the United States and targets 8:00am-5:00pm hours with occasional...Remote jobFraud
$24 - $43 per hour
...M&R Coding Clinical Analyst Optum is a global organization... ...are responsible to investigate, review and provide... ...on complex cases. Remote: You'll enjoy the... ...and trends, evidence of fraud, waste or abuse, and recommends... ...AAPC Certified coder (CPC, CCS, CCS-P) or Nurse (RN,...Remote workFraudHourly payMinimum wageFull timeContract workWork experience placementLocal area$56.2k - $101k
...partner is looking for a SIU Investigator based in the United... ...potential fraud, waste, and abuse (FWA)... ...information, financial records, coding documentation, and related... .... AHFI, CFE, CPC, CPMA, or another relevant... ...arrangements that may include remote, hybrid, field, or...Remote workFraudWork at officeFlexible hours- ...leading company in healthcare fraud prevention is seeking a... ...Coder or Clinical Coder/Fraud Investigator. This full-time role involves... ...and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a minimum of...Remote jobFraudFull time
- ...application. Healthcare Fraud Shield will not contact... ...Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES... ...to make appropriate coding determinations as... ...Professional Coder - (CPC) through governing body... ...development initiatives Remote work eligible REMOTE...Remote workFraudFull timeFlexible hours
- ...Compliance Investigator The Compliance Investigator is responsible for conducting and... ...in the corporate office, with remote work capability. We are seeking a... ...regulatory compliance Billing and coding concerns Fraud, waste, and abuse risks HIPAA privacy...Remote workFraudWork at office
- ...Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims data... ...fraud patterns Knowledge of healthcare coding, billing, and documentation standards...Remote workFraudFull time
$56.2k - $101k
...flexibility. Please note: this is a remote role with preference on... ...residing within Ohio.Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning... ...analyze health care claims and coding required. Pay Range: $56,200.00 -...Remote workFraudFull timePart timeWork at officeFlexible hours$60.2k - $107.4k
...have the flexibility to work remotely* as you take on some tough challenges... ...Collaborate with clinical coding consultant to apply knowledge... ...behavior through an Investigation Summary and compliance package... ...experience working in a FWA / SIU or Fraud investigations ~2+ years of...Remote workFraudMinimum wageFull timeWork experience placementLocal area$65k - $88.6k
...Healthcare Investigator Humana is looking for an experienced... ...passion for combating Fraud, Waste, and Abuse in... ...record reviews CPT code experience Experience... ...Clinical Certifications, CPC, CCS, CFE, AHFI)... ...Travel: While this is a remote position, occasional travel...Remote workFraudTemporary workWork at officeLocal areaWork from homeHome office$50k - $70k
Overview Certified Medical Coder (CPC or CCS) - Remote | WFH job at Get It - Healthcare. Springfield, NJ. Job Summary: We are looking for a detail... ...Medical Coder to join our team. As a key member of the coding department, you will be responsible for ensuring the accuracy...Remote jobFull timeWork at officeWork from homeMonday to FridayFlexible hoursShift work- ...a highly motivated Contract Coder to join our remote team. The ideal candidate must have at least 5 years of coding experience across various surgical specialties... ...compliance with HIPAA regulations. Certifications in CPC or CCS-P are mandatory, while additional...Remote workContract work
- ...a Division Manager, Talent Acquisition to manage coding operations for hospital settings, focusing on OB/... ...should have a HS Diploma and certification as a CPC or CCS-P, along with 2+ years' coding experience. This remote role offers a W2 contract-to-hire arrangement and...Remote workContract work
$62.7k - $97.2k
...and maintaining an anti-fraud program which includes... ...responsible for conducting investigations of organizational or... ...Professional Coder (CPC)* Certified Outpatient... ...(AHFI)* CPMA, CCA, or CCS**SKILLS*** Must have knowledge... ...processing systems and coding and billing proficiency...FraudFull timeContract workWork at officeLocal areaWork from home$56.2k - $101k
...Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals,... ...medical records, billing and coding documentation, provider... ...Professional Coder (CPC), Certified Professional... ...flexible approach to work with remote, hybrid, field or office...Remote workFraudFull timePart timeWork at officeFlexible hours- ...analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid... ..., but you will not manage anyone. Strong investigators here come from healthcare payer/vendor... ...(CFE). Certified Professional Coder (CPC). Accredited Health Care Fraud Investigator...Remote workFraud
$63.65k - $92.57k
...opportunities, and much more. The Fraud Analyst is building data... ...for MGB Health Plan's Special Investigations Unit; this role uses data... ...using knowledge of healthcare coding conventions, fraud schemes, and... ...generally 8:30-5:00 PM Eastern Time Remote workspace requirements,...Remote workFraudFull timeContract workWork at officeMonday to FridayFlexible hoursShift work$80.99k - $121.49k
...Point32Health. Job Summary The Investigator II is an essential team member... ...investigations related to fraud, waste, and abuse, and developing... ...guidelines, contract provisions, coding rules, coverage rules, and... ...Certified Professional Coder (“CPC”); Certified Fraud Examiner (“...FraudContract workWork at officeWork from homeFlexible hours- ...Remote Medical Coding Auditor (CPC, CCS-P, or CPMA) Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating...Remote workTemporary workMonday to FridayShift work
$72.7k
...developing and maintaining an anti-fraud program which includes... ...is responsible for conducting investigations of organizational or functional... ...Professional Coder (CPC) Certified Outpatient Coder (... ...claims processing systems and coding and billing proficiency Must...FraudContract workFor contractorsWork at officeLocal area- ...CODING SPECIALIST Location: REMOTE Employment Type: Full-Time Reports to: CGO... ...practice Certification: CPC (Certified Professional Coder... ...Medical Auditor), or CCS (Certified Coding Specialist... ...coding. Familiarity with fraud, waste, and abuse...Remote workFraudFull time
- ...Coder Assign ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in... ...facility encoder and EMR in an office or remote setting. Review and resolves coding edits... ...Certified Professional Coder (CPC) or CCS-P High School diploma, GED or equivalent...Remote workTemporary workLocal areaMonday to Friday
$75.35k - $98.89k
...a Senior Analyst, Special Investigations Unit Clinical Investigator... ...Work Location: This is a remote position, open to candidates... ...and necessity of billed CPC, HCPCS, and ICD-10 codes. Bonus points: Bachelor... ...Auditor (CPMA), Certified Fraud Examiner (CFE), Accredited...Remote workFraudFull timeWork at officeWork from homeFlexible hours3 days per week- ...duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices... ...deadlines are met. Qualifications: CPC/CCS-P with a minimum of 5 years of experience... ...laws and regulations, applicable fraud statutes and regulations, and of federal...Remote workFraudLocal area
$78k
...Fraud Investigator II Minimum Salary US-MA-Westborough Job Location 2 weeks... ...Day Shift Exempt Union Code (New!) Non Union Position - Non... ...following certifications or licensure: CPC or CPMA. Advanced SQL and Microsoft...FraudFull timeWork at officeShift work- ...Medical Coding SpecialistOptum is a global organization that delivers care, aided by technology, to help millions of people live... .../GEDCertified Coder with credentials from AAPC with a CPC or AHIMA with CCS, RHIT, RHIA3+ years of CPT coding experienceRecent professional...Remote workMinimum wageFull timeWork experience placementLocal areaMonday to FridayWeekend work
- ...The Certified Coder performs coding-focused medical review of Medicare... ...through AAPC or AHIMA: CPC, CCS, CCS-P, CRC, RHIA, or RHIT ~... ...independently and productively in a remote, technology-driven, queue-... ...documentation patterns indicative of fraud, waste, or abuse for referral...Remote workFraudContract workLocal area
$46.99k - $122.4k
...ability to determine correct coding and appropriate... ...regulators for any suspected fraud, waste, or abuse (FWA). The... .... Assisting with further investigation and/or reports to state regulators... ...~ Must possess an active CPC (Certified Professional Coder), CCS (Certified Coding...Remote workFraudHourly payFull timeMonday to FridayFlexible hours
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