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

Share this job:

Similar Jobs

Inventory Accountant

Posted 59 days ago

Prepare month-end inventory and COGS journals, Develop process improvements for inventory

Collaborate on annual audits, Provide data insights, Enhance inventory

Data Analysis Detail-oriented Financial Analysis Oracle

Senior EX Ops Coordinator

Posted 59 days ago

Support HR programs and maintain data accuracy

Enhance employee experience through process improvements

Communication Customer Service Data Management Google Suite

Indirect Tax Compliance Associate

Posted 59 days ago

Ensure global compliance with indirect tax regulations

Streamline VAT and Tourist Tax processes

Accounting Audit Compliance Data Analysis

Remote Technical Support Specialist

Posted 59 days ago

Provide remote technical support

Assist users in building apps

Communication Skills Customer Support Documentation Payment Operations

Transaction Monitoring Lead

Posted 59 days ago

Hiring a Transaction Monitoring Lead to enhance compliance capabilities

Optimizing TM rules and alert systems to reduce false positives

Automation Documentation Fraud Detection Monitoring

Legal Counsel, Fintech Remote

Posted 59 days ago

Provide comprehensive legal support across business functions

Ensure compliance in commercial and product operations

Compliance Corporate Governance Regulatory Compliance

Regional Compliance Officer

Posted 59 days ago

Lead regional compliance oversight for Airtm in India.

Implement and monitor AML/CFT measures for the region.

Anti-money Laundering Audit Communication Compliance

Legal Counsel - Airtm

Posted 59 days ago

Provide legal counsel on high-profile projects

Draft and negotiate contracts with various partners

Compliance Corporate Governance Licensing Project Management

Sales Floor Leader

Posted 59 days ago

Drive sales goals, Provide exceptional customer service, Manage inventory levels, Enforce company

licies, Support store

Communication Skills Financial Acumen Interpersonal Skills Organizational Skills

Remote QA Engineer

Posted 59 days ago

- Conduct thorough testing of Anagram's insurance billing software - Identify and report software

bugs and defects - Collaborate with the development team to ensure quality standards are met -

Agile Methodologies Communication Skills Database Management Problem-solving

Remote Accounting Manager Role

Posted 59 days ago

Hire experienced accounting manager

Enable full-time remote work

Accounting Accounts Receivable Analytical Skills Data Analysis

Remote Legal Operations Manager

Posted 59 days ago

Hire a remote Legal Operations Manager

Enhance legal process efficiency

Compliance Contract Management Legal Process Improvement

Remote Jobs Australia

Posted 59 days ago

. Connect job seekers with remote job opportunities in Australia. •

. Provide a user-friendly platform for job search. •

Content management systems Database Management Seo Optimization Social Media Marketing

Newspack Technical Account Manager

Posted 59 days ago

Manage and execute publisher migrations

Provide technical and strategic support to clients

Account manager Client Relationship Management Communication Skills Editing

Risk Analytics Wrangler Role

Posted 59 days ago

Strengthen risk management for Woo Payments and related products

Detect and prevent fraud in merchant and transaction domains

Analytics Data Analysis Fraud Detection Google Sheets

Software Dev Director - Cloud

Posted 59 days ago

Recruit an experienced Software Development Director for Cloud Delivery Engineering

Emphasize technical expertise in SaaS, IaaS, microservices, and security

Architecture Automation Cloud Platforms Customer Experience

Customer Success Implementation Consultant

Posted 59 days ago

Help non-profit organizations excel through product implementation and consulting

Maintain strong customer relationships

Communication Crm Customer Relations Database Management

Customer Support Team Lead

Posted 59 days ago

Lead and support a team of Support agents

Deliver performance evaluations and career discussions

Customer Support Leadership Performance evaluation Problem-solving

Staff Accountant at Blackbaud

Posted 59 days ago

Hiring a skilled Staff Accountant for Blackbaud.

Accounting operations and reporting responsibilities.

Accounting Audit Excel Microsoft Office

Staff Accountant Opportunity

Posted 59 days ago

Perform monthly close accounting operations

Prepare reconciliations and financial analysis

Accounting Analytical Skills Audit Automation

Senior Procurement Analyst Role

Posted 59 days ago

Ensure efficiency and accuracy in procurement operations

Maintain and manage vendor data and relationships

Analyst ERP Excel Process Improvement

Enterprise Risk Management Analyst

Posted 59 days ago

Develop and operationalize enterprise risk management programs

Assess and monitor enterprise-wide risks and internal controls

Analyst Communication Compliance Documentation

Client Success Representative

Posted 59 days ago

Enhance client and carrier satisfaction

Streamline supply chain processes

Collaboration Communication Customer Service Data Management

Bilingual Client Success Rep

Posted 59 days ago

Enhance client satisfaction and retention

Resolve issues and improve processes

Collaboration Communication Customer Service Documentation

Remote Support Specialist I

Posted 59 days ago

Hire a remote support specialist

Provide customer support for Brex

Analytical Skills Communication Communication Skills Customer Service

Brooklyn Liquor Store Manager

Posted 59 days ago

Lead warehouse operations, Improve KPIs, Drive financial performance, Ensure compliance, Develop

m

Budgeting Compliance Conflict resolution Financial Management

Remote Software Engineer Support

Posted 59 days ago

Enhance customer support processes through software solutions.

Collaborate with cross-functional teams to address technical issues.

Agile Methodologies Api Integration Customer Support Database Management

AP & AR Administrator

Posted 59 days ago

Support AP & AR functions for APAC region

Ensure compliance with financial policies and controls

Accounting Accounts Receivable Communication Communication Skills

Customer Success - Team Manager

Posted 59 days ago

Lead and support a global team of Customer Success Managers

Develop strategies to enhance customer engagement and retention rates

Account management Cloud Communication Skills Continuous improvement

Enterprise Project Manager Role

Posted 59 days ago

Deliver enterprise IT projects successfully

Engage and manage global stakeholders

Agile Agile Methodologies Cloud Cloud Technologies

Graduate HR Generalist APAC

Posted 59 days ago

Deliver proactive HR support to APAC team members

Maintain accurate HRIS and employment records

Communication Communication Skills Data Accuracy Documentation

Graduate Sales Development Role

Posted 59 days ago

Drive sales growth and business development

Identify and nurture new customer opportunities

Blockchain Business Development Communication Skills Crm Management

Remote Senior Business Administrator

Posted 59 days ago

Provide remote executive administrative support

Facilitate efficient business operations

Business Communication Calendar Management Process Improvement Project Coordination

Engineering Manager Growth

Posted 59 days ago

Lead and mentor engineering teams

Define and execute product strategy

Communication Skills Cross-functional Collaboration Data Analytics Process Improvement

Support Specialist Role

Posted 59 days ago

Provide comprehensive support for HR, IT, and Finance queries.

Manage and maintain employee records and documentation.

Automation Communication Data Management Documentation

Remote Staff Backend Engineer

Posted 59 days ago

Hiring a Staff Backend Engineer for a remote full-time position in Europe.

Accelerate developer productivity through backend system development.

Backend Development Database Management Engineer Java

HR Shared Services Manager

Posted 59 days ago

Hiring a Manager for HR Shared Services

Remote contract position

Collaboration Communication Compliance Employee Relations

Senior Counsel - Employment Compliance

Posted 59 days ago

Lead global employment and compliance strategy

Spearhead Future of Work in AI

Analytical Skills Communication Communication Skills Compliance

Senior Executive Assistant Manager

Posted 59 days ago

Provide comprehensive executive administrative support

Manage and mentor a team of executive assistants

Assistant Communication Communication Skills Documentation

Senior People Ops Associate

Posted 59 days ago

Manage HR operations & employee lifecycle

Support global projects and engagement programs

Communication Communication Skills Data Analysis Event Coordination

Senior Analytics Manager

Posted 59 days ago

Lead and develop a team of analysts

Collaborate with business leaders on experiments and success metrics

A/b Testing Ai Tools Analytics Apis

People Operations Senior Associate

Posted 59 days ago

Manage HR operations and employee lifecycle

Maintain and analyze HR data and systems

Communication Communication Skills Data Analysis Event Coordination

Finance Director - India

Posted 59 days ago

Direct and oversee financial operations of India office

Ensure compliance with accounting standards and regulations

Accounting Analytical Skills Auditing Budgeting

Teacher Support Associate Role

Posted 59 days ago

Lead and mentor teacher support agents

Drive operational improvements via data and metrics

Communication Skills Customer Support Data Analysis Leadership

Remote Customer Success Lead

Posted 59 days ago

Lead and manage the Customer Success team remotely

Drive customer success initiatives for high satisfaction and retention

Analytical Skills Communication Skills Customer success Customer Success Management