Clinical Investigator I (Special Investigation Unit)
Position Purpose: Audit medical records to identify inappropriate billing practices and recommend next steps through extensive review of claims data, medical records, corporate policy, state/federal policy, and practice standards. Key Details: Preferred qualifications include coding certification, nurse coding experience, and experience with CPT coding. • Perform retrospective and prepayment reviews of medical records to identify potential abuse and fraud and inappropriate...
- Audit
- Workday