SIU Coding Auditor

New

Skills

Auditing Database Management Data Interpretation Fraud Detection Medical Coding Process Improvement Regulatory Compliance

Job Overview

Execute Oscar's anti-fraud initiatives within the SIU Coding Auditor program. Support audit strategy to meet targets while ensuring quality and regulatory compliance. Collaborate across partners and recommend process improvements for Fraud, Waste and Abuse. Review dashboards and interpret performance data to support production goals and deadlines.

Responsibilities
  • Perform complex reviews of medical records and claims (pre- and post-payment) for accuracy
  • Document findings with sources and present clearly to providers and non-clinicians
Requirements & Qualifications
  • Bachelor's degree or equivalent years of experience
  • CPC designation or similar
  • 3+ years coding or auditing experience across multiple specialties
  • Bonus: Certified Professional Medical Auditor (CPMA) or similar
  • Bonus: Additional certifications such as CFE, AHFI, or CAFP
  • Bonus: HIPAA, data privacy, and data security knowledge; experience with regulators

No forms. Your profile is generated instantly.

Job Type: Remote

Salary: Not Disclosed

Experience: Entry

Duration: 12 Months

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