SIU Analyst

Healthcare Fraud Shield•Chesterfield, MO
•Remote

About The Position

Healthcare Fraud Shield, a leader in healthcare fraud prevention and payment integrity solutions, is looking for a talented SIU Analyst to join our team.

Requirements

  • Basic knowledge of medical terminology.
  • Basic knowledge of coding concepts, including CPT, HCPCS, and ICD-10.
  • Basic knowledge of specialty medical practices.
  • Attention to detail.
  • Ability to communicate clearly and effectively, both verbally and in writing.
  • Good listening skills.
  • Ability to work both independently and as part of a team.
  • Responsible and self-disciplined.
  • Ability to meet defined performance and production goals.
  • Basic computer skills.
  • Discretion and secure information management are essential.
  • Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.

Nice To Haves

  • No specific investigative experience is required, but healthcare knowledge and a strong interest in medical claims, coding, and investigations is a plus.

Responsibilities

  • Assist and support the SIU team (Managers, Clinical Reviewers, CPCs, Investigators, and Analysts) with daily tasks.
  • Help with the intake and triage of client-assigned tasks.
  • Assist in the analysis of patient medical records for FWA investigations.
  • Support the comparison of medical records to claim information to determine billable services.
  • Help with documenting findings for each claim line in a spreadsheet.
  • Contribute to summarizing findings in a written report.
  • Assist with abstracting CPT, HCPCS, Revenue Codes, DRG codes, and ICD-9/ICD-10 from medical records.
  • Support the team in maintaining current knowledge of coding guidelines and regulations.
  • Assist with data analysis of client data.
  • Provide basic support for various aspects of FWA investigations.
  • Comply with all company Privacy and Security standards.
  • Understand and follow all company Privacy and Security standards.
  • Respect and protect confidential and sensitive information, including protected health information.
  • Perform other duties as assigned.

Benefits

  • Medical, Dental & Vision insurance
  • 401(k) retirement savings with employer match
  • Vacation and sick paid time off
  • 7 paid holidays & 2 floating holidays
  • Paid maternity/paternity leave
  • Disability & Life insurance
  • Flexible Spending Account (FSA)
  • Employee Assistance Program (EAP)
  • Professional and career development initiatives
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