Coding Investigator Auditor - Work From Home

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Job Summary

This position is responsible for auditing clinical, billing, coding and lowest cost setting reviews for services pre and post payment utilizing medical, contractual, legislative, policy, and other information to validate claims submitted and billed. Conducting research. Preparing documentation of findings and consulting with special investigation and the affordability of care area as needed. Coordinating with all departments involved in each case required such as medical director special investigations, customer service, pass, network management, marketing, case management, medical review, legal, pricing and database. Required Job Qualifications: