State Licensed Clinical InvestigatorVirtualVocations • Santa Clara, California, United States
State Licensed Clinical Investigator
VirtualVocations • Santa Clara, California, United States
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A company is looking for a Clinical Investigator I in the Special Investigation Unit.
Key Responsibilities
Conduct reviews and audits of medical records to ensure accurate coding and billing practices
Perform retrospective and prepayment reviews to identify potential abuse, fraud, and inappropriate billing practices
Investigate and analyze provider billing patterns to recommend payments based on medical records and regulatory guidelines
Required Qualifications, Training, and Education
Associate's degree in a related field or equivalent experience preferred
Coding certification (CPC or CCS) and 2+ years of medical coding experience, or a relevant healthcare license with 2+ years of clinical experience
Experience in provider education preferred
Licensing from an accredited organization (AAPC or AHIMA) is required
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Clinical Investigator • Santa Clara, California, United States
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