SIU Coding Investigator: Fraud & FWA
molina talent acquisitionNew York, NY
SIU Coding Investigator: Fraud & FWA
L5
molina talent acquisitionNew York, NY5 days ago
Occupations
Fraud Examiners, Investigators and AnalystsHealth Information Technologists and Medical RegistrarsClaims Adjusters, Examiners, and InvestigatorsIndustries
General Medical and Surgical HospitalsOffices of PhysiciansPharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsMolina Healthcare is seeking a skilled investigator specializing in medical provider coding fraud, waste, and abuse (FWA) within the SIU. You will re-evaluate claims using CPT coding knowledge and applicable federal/state regulations, reviewing post-pay claims against records to ensure payment accuracy.
Responsibilities include prioritizing caseloads, preparing clinical summaries, and supporting investigations for potential referrals or recovery, with emphasis on compliance and collaboration in
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Level
SeniorL5
Location
New York, NY
Occupation
Fraud Examiners, Investigators and Analysts
Industry
General Medical and Surgical Hospitals
Posted
5 days ago
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