Commonwealth Care Alliance
FWA Investigator Coder Sr. Associate (Remote)
Commonwealth Care Alliance, Boston, Massachusetts, us, 02298
Employer Industry:
Healthcare Compliance
Why consider this job opportunity:Competitive salary up to $80,000Opportunity for career advancement and growth within the organizationRemote work flexibilitySupportive and collaborative team environmentChance to make a positive impact on healthcare compliance and fraud prevention
What to Expect (Job Responsibilities):Conduct prospective and retrospective medical record reviews of claimsWrite detailed Memorandum of Findings for retrospective reviewsReview internal and external referrals, claims, and medical records for complianceDocument and track investigative activity in internal databaseUtilize data mining programs to analyze claims data for suspicious patterns
What is Required (Qualifications):Bachelor's Degree or equivalent experienceCPC medical coding backgroundProficiency in Microsoft OfficeExperience and knowledge of CPT CodingKnowledge of federal and state laws related to fraud, waste, and abuse
How to Stand Out (Preferred Qualifications):Prior experience in health care compliance or related fieldBackground in facility coding
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Healthcare Compliance
Why consider this job opportunity:Competitive salary up to $80,000Opportunity for career advancement and growth within the organizationRemote work flexibilitySupportive and collaborative team environmentChance to make a positive impact on healthcare compliance and fraud prevention
What to Expect (Job Responsibilities):Conduct prospective and retrospective medical record reviews of claimsWrite detailed Memorandum of Findings for retrospective reviewsReview internal and external referrals, claims, and medical records for complianceDocument and track investigative activity in internal databaseUtilize data mining programs to analyze claims data for suspicious patterns
What is Required (Qualifications):Bachelor's Degree or equivalent experienceCPC medical coding backgroundProficiency in Microsoft OfficeExperience and knowledge of CPT CodingKnowledge of federal and state laws related to fraud, waste, and abuse
How to Stand Out (Preferred Qualifications):Prior experience in health care compliance or related fieldBackground in facility coding
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