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SIU Analyst

Healthcare Fraud Shield

Role overview

Qualifications

  • Basic knowledge of medical terminology
  • Basic knowledge of coding concepts, including CPT, HCPCS, and ICD-10
  • Attention to detail
  • Ability to communicate clearly and effectively, both verbally and in writing

Responsibilities

  • Assist and support the SIU team 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

Key facts

Hard skills

Other skills

  • Detail Oriented
  • Communication
  • Active Listening
  • Teamwork
  • Self-Discipline

About the company

Healthcare Fraud Shield logo

Healthcare Fraud Shield

Healthcare Fraud Shield provides new and unique Fraud, Waste and Abuse (FWA) automated solutions to the healthcare industry. Our exclusive data solutions and investigative expertise deliver maximum results in the detection and prevention against fraud. Leveraging our comprehensive fraud experience, we deliver fresh insights and new approaches to combat the largest challenge of our time - the delivery of honest, efficient and compassionate healthcare.

Company details

Company typeSME
Industry
Company size11 - 50

Links

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Job description

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

Skills, Knowledge and Expertise
  • 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.
  • This job requires access to confidential and sensitive information, which means discretion and secure information management are essential.

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


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
  • Remote work eligible

REMOTE WORK REQUIREMENTS:
  • Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.

Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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