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Coding Siu Jobs in New York (NOW HIRING)

Essen Healthcare

Be Seen First

Director of Coding Compliance

Bronx, NY · On-site

$85K - $110K/yr

Partner with Compliance, SIU, Clinical Operations, Provider Education, and RCM teams to support organizational initiatives. * Develop and deliver provider and staff education related to coding ...

EmblemHealth

Senior Investigator

New York, NY · On-site

Conduct medical records assessments, and CPT coding issues. * Provide guidance and mentor to the Fraud Investigators. * Answer and respond to SIU Fraud Hotline cases when assigned based on schedule.

EmblemHealth

Senior Investigator

New York, NY · On-site

$68K - $118K/yr

Conduct medical records assessments, and CPT coding issues. * Provide guidance and mentor to the Fraud Investigators. * Answer and respond to SIU Fraud Hotline cases when assigned based on schedule.

MedReview

Business Analyst - Operations

Manhattan, NY · Remote

$80K/yr

Knowledge of medical coding standards (ICD, CPT, HCPCS). * Familiarity with payer SIU/FWA operations or subrogation. * Exposure to Agile methodologies and tools such as Jira/Confluence. Success ...

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Coding Siu information

What is the difference between Coding Siu vs Coding Technician?

AspectCoding SiuCoding Technician
Required CredentialsCertification in coding standards, possibly a diploma or certificate in medical codingCertification in coding or health information technology, often a diploma or associate degree
Work EnvironmentHealthcare facilities, clinics, hospitalsMedical offices, hospitals, outpatient clinics
Employer & Industry UsageUsed by healthcare providers for billing and record-keepingEmployed in healthcare settings for coding and documentation
Common Search & ComparisonOften compared for roles in medical coding and billingRelated 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.

What are popular job titles related to Coding Siu jobs in New York? For Coding Siu jobs in New York, the most frequently searched job titles are:
What job categories do people searching Coding Siu jobs in New York look for? The top searched job categories for Coding Siu jobs in New York are:
What cities in New York are hiring for Coding Siu jobs? Cities in New York with the most Coding Siu job openings:
Coding Siu jobs near you
Infographic showing various Coding Siu job openings in New York as of August 2026, with employment types broken down into 89% Full Time, and 11% Temporary. Highlights an 77% In-person, and 23% Remote job distribution.

Special Investigations Unit Clinical Certified Coder

MetroPlusHealth

Manhattan, NY • On-site

$100K - $110K/yr

Full-time

Re-posted 12 days ago

MetroPlusHealth rating

6.7

Company rating: 6.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

264th of 304 rated insurance

Job description

Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.
Position Overview
MetroPlusHealth is seeking a highly qualified candidate for a Clinical Coder role within our Special Investigations Unit. The Clinical Certified Coder will support the Plan in the detection, prevention and investigation of suspected fraud, waste, and abuse. The position reports to the Director of Special Investigations Unit.
Scope of Role & Responsibilities
  • Review medical records and healthcare claims to determine the accuracy and compliance of billed codes with appropriate regulations, standards, policies and procedures.
  • Conduct audits of high-risk claims and billing patterns to ensure adherence to healthcare regulation and
  • MetroPlusHealth policy and detect potential FWA.
  • Collaborate with other SIU team members to evaluate suspected cases of fraudulent activities, such as over-utilization of services, upcoding, and billing for non-medically necessary services.
  • Create detailed reports with medical review findings that include research, rationale, sources and corrective action recommendations to the SIU Department. The reports will also validate whether audited claims should be denied, recouped and if other mitigation strategies are required.
  • Participate as needed on provider calls to discuss findings and rationale of medical review.
  • Present findings to leadership and other stakeholders to facilitate all FWA proceedings.
  • Assist in preparing documentation for audits, recoupments, compliance/legal reviews and regulatory inquiries.
  • Maintain thorough documentation of investigations, including clinical findings, coding discrepancies and all communication with healthcare providers and investigators.
  • Stay updated to changes to coding guidelines, healthcare regulations, and fraud detection methods to ensure compliance and effective investigations.
  • Completes special projects and audits as required.

Required Education, Training & Professional Experience
  • 5 years of experience in healthcare fraud detection, investigation, or auditing
  • In depth experience and knowledge of coding regulations including ICD-10, CPT, HCPCS, AMA etc.
  • AAPC Coding certification - Certified Professional Coder (CPC), Certified Professional Medical
  • Auditor (CPMA) or Certified Coding Specialist (CCS)
  • Bachelor's degree in Nursing, Medical Billing/Medical Coding, Healthcare or other related fields
  • Preferred candidate will have experience in Medicaid, Medicare, and Marketplace/Exchange

Licensure and/or Certification Required:
  • AAPC Coding certification - Certified Professional Coder (CPC), Certified Professional Medical
  • Auditor (CPMA) or Certified Coding Specialist (CCS) - Required
  • Valid New York State license and current registration to practice as a Registered Professional Nurse
  • (RN) issued by the New York State Education Department (NYSED).

Professional Competencies:
  • Integrity and Trust
  • Customer Focus
  • Excellent Microsoft Office Suite skills
  • Strong communication skills to interact with providers, medical management, legal teams, and
  • compliance departments.
  • Strong analytical, research and problem-solving aptitude with attention to detail and accuracy

#LI-Hybrid #MPH50

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