SIU Code Auditor
Worcester, MA · On-site
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check ... Coding and audit review: Perform detailed reviews and audits of medical records to verify the ...
SIU Code Auditor
Worcester, MA · On-site
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check ... Coding and audit review: Perform detailed reviews and audits of medical records to verify the ...
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check ... Coding and audit review: Perform detailed reviews and audits of medical records to verify the ...
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check ... Coding and audit review: Perform detailed reviews and audits of medical records to verify the ...
SIU Code Auditor
Worcester, MA · On-site
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check ... Coding and audit review: Perform detailed reviews and audits of medical records to verify the ...
SIU Code Auditor
Worcester, MA · On-site
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check ... Coding and audit review: Perform detailed reviews and audits of medical records to verify the ...
SIU Investigator IV
Minnetonka, MN · On-site
The SIU Investigator IV leads advanced investigations into suspected fraud, waste, and abuse ... Understanding of claim billing codes, medical terminology, anatomy, and health care delivery ...
SIU Investigator IV
Minnetonka, MN · On-site
The SIU Investigator IV leads advanced investigations into suspected fraud, waste, and abuse ... Understanding of claim billing codes, medical terminology, anatomy, and health care delivery ...
Certified Coder, Special Investigations Unit (SIU)
Akron, OH · On-site
$28.10 - $42.15/hr
Certified Coder, Special Investigations Unit (SIU) SummaCare - 1200 E Market St, Akron, OH ... Determines correct coding and appropriate documentation required while ensuring state, federal and ...
Certified Coder, Special Investigations Unit (SIU)
Akron, OH · On-site
$28.10 - $42.15/hr
Certified Coder, Special Investigations Unit (SIU) SummaCare - 1200 E Market St, Akron, OH ... Determines correct coding and appropriate documentation required while ensuring state, federal and ...
SIU Lead Investigator
Minneapolis, MN · On-site
$102K - $121K/yr
Collaborate with SIU Investigator to apply knowledge of coding guidelines to determine validity of aberrances. * Gather all relevant facts to articulate behavior through an Investigation Summary and ...
SIU Lead Investigator
Minneapolis, MN · On-site
$102K - $121K/yr
Collaborate with SIU Investigator to apply knowledge of coding guidelines to determine validity of aberrances. * Gather all relevant facts to articulate behavior through an Investigation Summary and ...
SIU Lead Investigator
Minneapolis, MN · Remote
$102K - $121K/yr
Collaborate with SIU Investigator to apply knowledge of coding guidelines to determine validity of aberrances. * Gather all relevant facts to articulate behavior through an Investigation Summary and ...
SIU Lead Investigator
Minneapolis, MN · Remote
$102K - $121K/yr
Collaborate with SIU Investigator to apply knowledge of coding guidelines to determine validity of aberrances. * Gather all relevant facts to articulate behavior through an Investigation Summary and ...
SIU Investigator - Nashville, TN
Nashville, TN · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Nashville, TN
Nashville, TN · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Detroit, MI
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
SIU Investigator - Detroit, MI
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
Quick apply
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
SIU Investigator - Miami, FL
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Miami, FL
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Dallas, TX
Dallas, TX · Remote
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
Quick apply
SIU Investigator - Dallas, TX
Dallas, TX · Remote
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Detroit, MI
Detroit, MI · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
SIU Investigator - Detroit, MI
Detroit, MI · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
SIU Investigator - Nashville, TN
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Nashville, TN
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
Quick apply
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Miami, FL
Miami, FL · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Miami, FL
Miami, FL · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Dallas, TX
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Dallas, TX
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
Quick apply
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Newark, NJ
Newark, NJ · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - Newark, NJ
Newark, NJ · On-site
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
SIU Investigator - San Jose, CA
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
SIU Investigator - San Jose, CA
$30 - $40/hr
... carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and ... codes, and governing agencies. * Provide Claim Adjuster with timely investigation results and ...
New
Coding Siu information
Can you make 100k as a medical coder?
Coding Siu, as a medical coder, can potentially earn $100,000 or more annually, especially with experience, certifications like CPC or CCS, and working in high-demand specialties or supervisory roles. However, salaries vary based on location, employer, and level of expertise, with many coders earning between $40,000 and $70,000 per year on average.
Will a medical coder be replaced by AI?
Medical coders, including those in coding roles like Coding Siu, perform complex tasks such as reviewing medical records and applying coding standards that require critical thinking and clinical knowledge. While AI tools can assist with coding accuracy and efficiency, they are unlikely to fully replace human coders due to the need for judgment, interpretation, and understanding of medical documentation. Professionals in this field should focus on developing expertise in coding systems and staying updated with technological advancements to complement AI tools.
What is the highest paid coding job?
Senior software engineers, especially those working in specialized fields like machine learning, artificial intelligence, or blockchain development, tend to have the highest salaries in coding roles. Roles such as software architects or technical leads also command top compensation, often exceeding six figures annually depending on experience and industry.
What is the difference between Coding Siu vs Coding Technician?
| Aspect | Coding Siu | Coding Technician |
|---|---|---|
| Required Credentials | Certification in coding standards, possibly a diploma or certificate in medical coding | Certification in coding or health information technology, often a diploma or associate degree |
| Work Environment | Healthcare facilities, clinics, hospitals | Medical offices, hospitals, outpatient clinics |
| Employer & Industry Usage | Used by healthcare providers for billing and record-keeping | Employed in healthcare settings for coding and documentation |
| Common Search & Comparison | Often compared for roles in medical coding and billing | Related but more technical, focusing on coding accuracy |
Both Coding Siu and Coding Technician roles involve medical coding, but Coding Siu typically emphasizes billing and insurance claims, while Coding Technicians focus more on accurate medical record coding. They share similar credentials and work environments, making them closely related in the healthcare industry.
Are medical coders still in demand?
Medical coders are still in demand due to ongoing healthcare needs and the shift toward electronic health records. The role requires knowledge of coding systems like ICD-10 and CPT, and certifications such as CPC can enhance job prospects. The demand is expected to remain stable as healthcare providers seek accurate billing and compliance.
More about Coding Siu jobs
What cities are hiring for Coding Siu jobs? Cities with the most Coding Siu job openings:
What states have the most Coding Siu jobs? States with the most job openings for Coding Siu jobs include:
What job categories do people searching Coding Siu jobs look for? The top searched job categories for Coding Siu jobs are:
Fallon Health rating
7.3
Based on 13 frontline employees who took The Breakroom Quiz
Job description
Overview
About us:
Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.
Brief summary of purpose:
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check for missing documentation and other medical documentation for E&M, DME, medical, home health services, and may include some behavioral health care services to identify potential over-payments and suspected fraud waste and abuse. Serve as a clinical and code liaison for fraud, waste and abuse team while identifying areas of vulnerability and risk.
Responsibilities
Primary Job Responsibilities (include duties that represent 5% or more of employee's time)
The Internal Audit Department (IA) at Fallon Health serves as the company's designated Special Investigation Unit (SIU) for fraud, waste, and abuse (FWA) activity. The department reports administratively to the Chief Compliance Officer and functionally to the Audit & Compliance Committee, and it plays a central role in detecting, reviewing, and addressing potential fraud, waste, and abuse.
In this role, the SIU Code Auditor is responsible for reviewing medical records, identifying coding and billing concerns, supporting investigations, and communicating findings and recommendations to internal and external stakeholders. This also includes tracking of cases assigned and maintaining documentation to department standards and assisting with reports due to both internal and external partners.
Qualifications
Education
Bachelor's degree preferred or equivalent experience, and prior experience in healthcare
License/Certifications
Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) is required. Clinical Experience is preferred.
Certified Evaluation and Management Coder (CEMC) or Certified Professional Medical Auditor (CPMA) are a plus.
Experience:
,,Pay Range Disclosure:
In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $87,500 annually which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities.
Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
About us:
Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.
Brief summary of purpose:
The SIU Code Auditor will conduct coding audits of medical records provided by providers to check for missing documentation and other medical documentation for E&M, DME, medical, home health services, and may include some behavioral health care services to identify potential over-payments and suspected fraud waste and abuse. Serve as a clinical and code liaison for fraud, waste and abuse team while identifying areas of vulnerability and risk.
Responsibilities
Primary Job Responsibilities (include duties that represent 5% or more of employee's time)
The Internal Audit Department (IA) at Fallon Health serves as the company's designated Special Investigation Unit (SIU) for fraud, waste, and abuse (FWA) activity. The department reports administratively to the Chief Compliance Officer and functionally to the Audit & Compliance Committee, and it plays a central role in detecting, reviewing, and addressing potential fraud, waste, and abuse.
In this role, the SIU Code Auditor is responsible for reviewing medical records, identifying coding and billing concerns, supporting investigations, and communicating findings and recommendations to internal and external stakeholders. This also includes tracking of cases assigned and maintaining documentation to department standards and assisting with reports due to both internal and external partners.
- Coding and audit review: Perform detailed reviews and audits of medical records to verify the accuracy of coding and charges for services provided. Review provider documentation and professional services using ICD-10, CPT, HCPCS, and applicable federal, state, local, payer, Medicare, Medicaid, LCD, NCD, and internal policy requirements.
- Investigative support: Review clinical and coding investigative summaries, including those prepared by external parties, to support findings of potential fraud, waste, or abuse. Provide feedback and recommendations to investigators and management.
- Pattern and risk identification: Identify aberrant billing patterns, trends, and indicators of fraud, waste, or abuse. Recommend providers for further review, conduct root cause analysis as needed, and suggest process or program improvements to leadership.
- Provider and stakeholder collaboration: Meet with providers to discuss audit findings and improvement opportunities. Work closely with clinical teams, coding teams, Medical Directors, external partners, and providers to support accurate billing and effective case resolution.
- Reporting, education, and regulatory support: Assist with claim denial reporting, respond to regulatory agency complaints, support required fraud reporting to state and federal agencies, and recommend to members, providers, or employee education based on findings.
- Case management and professional standards: Manage daily case review assignments with a strong emphasis on quality, provide regular updates to department leadership and senior management, maintain current knowledge of coding guidelines related to professional services, and perform other duties as assigned.
- Core work style expectations: Communicate effectively in writing and verbally, demonstrate strong listening skills, work independently, and consistently meet deadlines.
- Reports and Metrics: Communicate results to the team and help maintain and update key departmental reports and metrics.
- Administrative Functions: Perform administrative tasks that support daily operations, case tracking, documentation, and overall departmental workflow; including incoming and outgoing emails.
Qualifications
Education
Bachelor's degree preferred or equivalent experience, and prior experience in healthcare
License/Certifications
Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) is required. Clinical Experience is preferred.
Certified Evaluation and Management Coder (CEMC) or Certified Professional Medical Auditor (CPMA) are a plus.
Experience:
- 3-4 years of relevant experience.
- Demonstrated proficiency in medical record audits and analysis and ICD-10CM/CPT coding methodology, HCPCS Coding systems and guidelines and knowledge and understanding of medical terminology.
- Knowledge of billing and other coding edits, as well as Centers for Medicare and Medicaid Services (CMS) local and national coverage determinations, and managed billing regulations.
- Strong quantitative, analytical, interpersonal, written and communication skills
- Understanding in fraud, waste abuse regulations, or any combination of education and experience, which would provide an equivalent background
,,Pay Range Disclosure:
In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $87,500 annually which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities.
Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
What Fallon Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom