Clinical Provider Auditor II - Payment Integrity SIU Clinical Provider Auditor II - Payment ... Requires coding certification (CPC, CCS, CPMA). Preferred Experience: * Prepay review of Medicare ...
Clinical Provider Auditor II - Payment Integrity SIU Clinical Provider Auditor II - Payment ... Requires coding certification (CPC, CCS, CPMA). Preferred Experience: * Prepay review of Medicare ...
Clinical Provider Auditor II - Payment Integrity SIU Clinical Provider Auditor II - Payment ... Requires coding certification (CPC, CCS, CPMA). Preferred Experience: * Prepay review of Medicare ...
Clinical Provider Auditor II - Payment Integrity SIU Clinical Provider Auditor II - Payment ... Requires coding certification (CPC, CCS, CPMA). Preferred Experience: * Prepay review of Medicare ...
Special Investigations Unit Clinical Certified Coder
Manhattan, NY · Hybrid
$100K - $110K/yr
Collaborate with other SIU team members to evaluate suspected cases of fraudulent activities, such ... Stay updated to changes to coding guidelines, healthcare regulations, and fraud detection methods ...
Special Investigations Unit Clinical Certified Coder
Manhattan, NY · Hybrid
$100K - $110K/yr
Collaborate with other SIU team members to evaluate suspected cases of fraudulent activities, such ... Stay updated to changes to coding guidelines, healthcare regulations, and fraud detection methods ...
Special Investigations Unit Clinical Certified Coder
Manhattan, NY · On-site
$100K - $110K/yr
Collaborate with other SIU team members to evaluate suspected cases of fraudulent activities, such ... Stay updated to changes to coding guidelines, healthcare regulations, and fraud detection methods ...
Special Investigations Unit Clinical Certified Coder
Manhattan, NY · On-site
$100K - $110K/yr
Collaborate with other SIU team members to evaluate suspected cases of fraudulent activities, such ... Stay updated to changes to coding guidelines, healthcare regulations, and fraud detection methods ...
Clinical Provider Auditor II - Payment Integrity SIU Clinical Provider Auditor II - Payment ... Requires coding certification (CPC, CCS, CPMA). Preferred Experience: * Prepay review of Medicare ...
Clinical Provider Auditor II - Payment Integrity SIU Clinical Provider Auditor II - Payment ... Requires coding certification (CPC, CCS, CPMA). Preferred Experience: * Prepay review of Medicare ...
Investigator III
Honolulu, HI · Hybrid
... coding topics and FWA trends/schemes; Special Investigation case studies). * SIU case investigation management, resolution and prevention. * Initiate, analyze, develop, and resolve proactive FWA ...
Investigator III
Honolulu, HI · Hybrid
... coding topics and FWA trends/schemes; Special Investigation case studies). * SIU case investigation management, resolution and prevention. * Initiate, analyze, develop, and resolve proactive FWA ...
Investigator III
Honolulu, HI · Hybrid
... coding topics and FWA trends/schemes; Special Investigation case studies). * SIU case investigation management, resolution and prevention. * Initiate, analyze, develop, and resolve proactive FWA ...
Investigator III
Honolulu, HI · Hybrid
... coding topics and FWA trends/schemes; Special Investigation case studies). * SIU case investigation management, resolution and prevention. * Initiate, analyze, develop, and resolve proactive FWA ...
Investigator III
Honolulu, HI · On-site
... coding topics and FWA trends/schemes; Special Investigation case studies). * SIU case investigation management, resolution and prevention. * Initiate, analyze, develop, and resolve proactive FWA ...
Investigator III
Honolulu, HI · On-site
... coding topics and FWA trends/schemes; Special Investigation case studies). * SIU case investigation management, resolution and prevention. * Initiate, analyze, develop, and resolve proactive FWA ...
Director of Coding Compliance
Bronx, NY · On-site
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 ...
Director of Coding Compliance
Bronx, NY · On-site
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 ...
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 ...
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 ...
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 ...
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 ...
Investigator, Special Investigative Unit (Remote)
Long Beach, CA · On-site +1
$19.64 - $42.55/hr
... coding accuracy and excellence. Essential Job Duties • Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
Investigator, Special Investigative Unit (Remote)
Long Beach, CA · On-site +1
$19.64 - $42.55/hr
... coding accuracy and excellence. Essential Job Duties • Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
Investigator, Special Investigative Unit (Remote)
Long Beach, CA · On-site +1
$19.64 - $42.55/hr
... coding accuracy and excellence. Essential Job Duties • Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
Investigator, Special Investigative Unit (Remote)
Long Beach, CA · On-site +1
$19.64 - $42.55/hr
... coding accuracy and excellence. Essential Job Duties • Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
This role works collaboratively with the entire SIU team and communicates with internal business ... Minimum of three (3) years experience in healthcare coding directly related to determining ...
This role works collaboratively with the entire SIU team and communicates with internal business ... Minimum of three (3) years experience in healthcare coding directly related to determining ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
Casualty SIU Investigator
New York, NY · On-site
Casualty SIU Investigator As a critical part of the Casualty Claim discipline, this position is ... Adhering to Chubb service standards, Chubb code of professional conduct, statutory regulations, and ...
Casualty SIU Investigator
New York, NY · On-site
Casualty SIU Investigator As a critical part of the Casualty Claim discipline, this position is ... Adhering to Chubb service standards, Chubb code of professional conduct, statutory regulations, and ...
This role works collaboratively with the entire SIU team and communicates with internal business ... Minimum of three (3) years experience in healthcare coding directly related to determining ...
This role works collaboratively with the entire SIU team and communicates with internal business ... Minimum of three (3) years experience in healthcare coding directly related to determining ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
... coding accuracy and excellence. Essential Job Duties Responsible for developing leads presented to the special investigation unit (SIU) to assess and determine whether potential fraud, waste, or ...
Coding Siu information
What jobs pay $10,000 a month without a degree?
Will a medical coder be replaced by AI?
Is a medical coder still in demand?
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.
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Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 12 days ago
Elevance Health rating
7.8
Based on 334 frontline employees who took The Breakroom Quiz
164th of 261 rated insurance
Job description
Anticipated End Date:
2026-06-15Position Title:
Clinical Provider Auditor II - Payment Integrity SIUJob Description:
Clinical Provider Auditor II - Payment Integrity SIU
Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Carelon, a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center-connecting physical, behavioral, social, and pharmacy services, along with clinical expertise, research, operations, and advanced technology to help care work better, together.
Among us are care providers, engineers, data scientists, and other dedicated professionalsdetermined to recover, eliminate and prevent unnecessary medical-expense spending.
The Clinical Provider Auditor II is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse.
How you will make an impact:
Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control.
Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations and continue to next step in the claims lifecycle.
Researches new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations.
Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern.
Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.
Assists with training of new associates.
Minimum Requirements:
Requires a AA/AS and minimum of 3 years medical coding/auditing experience, including minimum of 1 year in fraud, waste abuse experience; or any combination of education and experience, which would provide an equivalent background.
Requires coding certification (CPC, CCS, CPMA).
Preferred Experience:
Prepay review of Medicare and Medicaid experience highly desired.
Knowledge of ICD-10 and CPT/HCPC coding guidelines and terminology and Bachelor's degree strongly preferred.
Job Level:
Non-Management ExemptWorkshift:
1st Shift (United States of America)Job Family:
FRD > AuditPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.
What Elevance Health employees say
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Benefits
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Get the full story on Breakroom
About Elevance Health
Sourced by ZipRecruiter
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Indianapolis, IN, US
Year founded
2004