SIU Analyst
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.
- 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
- Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.
Basic knowledge of medical terminology, coding concepts (CPT, HCPCS, ICD-10), and specialty practices; attention to detail; communication skills; basic computer skills; remote work requires high-speed internet (25 Mbps download, 5 Mbps upload).
Key Responsibilities
- assisting SIU team
- analyzing medical records
- documenting findings
Job Details
- Category: Data and Analytics
- Seniority: No Prior Experience Required
- Commitment: Full Time
- Workplace: Remote — Chesterfield, Missouri, United States
- Languages: English
Benefits
- 401k matching
- Generous paid time off
- Retirement plan
- Generous parental leave
About Healthcare Fraud Shield
A provider of AI-powered solutions to detect and prevent healthcare fraud, waste, abuse, and error for healthcare payers. — Industry: Information Technology