Medical Coding * Criminal Justice * Public Health * Related healthcare field - Experience * 2-5+ ... Fraud, Waste, and Abuse investigations * Medicare and Medicaid programs * Claims auditing
Medical Coding * Criminal Justice * Public Health * Related healthcare field - Experience * 2-5+ ... Fraud, Waste, and Abuse investigations * Medicare and Medicaid programs * Claims auditing
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. * Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. * Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Minimum of 5 years of experience in fraud, waste, and abuse (FWA), payment integrity, healthcare compliance, claims auditing, claims analysis, or related healthcare operations functions. Experience ...
Medical Review Auditor (Fraud Waste and Abuse)
$70K - $91K/yr
Overview As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. Responsibilities
Medical Review Auditor (Fraud Waste and Abuse)
$70K - $91K/yr
Overview As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. Responsibilities
Medical Review Auditor (Fraud Waste and Abuse)
$70K - $91K/yr
Overview As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. Responsibilities
Medical Review Auditor (Fraud Waste and Abuse)
$70K - $91K/yr
Overview As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. Responsibilities
Single. Day. Aspirus Health in Wausau, WI is seeking a FRAUD WASTE ABUSE ANALYST to join our ... Knowledge of CPT, HCPCS, and ICD-10 coding and medical terminology. * Familiarity with CMS ...
Single. Day. Aspirus Health in Wausau, WI is seeking a FRAUD WASTE ABUSE ANALYST to join our ... Knowledge of CPT, HCPCS, and ICD-10 coding and medical terminology. * Familiarity with CMS ...
Senior Analyst, Healthcare Fraud, Waste and Abuse
$97K - $110K/yr
Reporting & Fraud, Waste & Abuse Analytics * Lead and expand reporting and analytics programs to generate insights and drive actions supporting Program Integrity and Fraud, Waste & Abuse (FWA ...
Senior Analyst, Healthcare Fraud, Waste and Abuse
$97K - $110K/yr
Reporting & Fraud, Waste & Abuse Analytics * Lead and expand reporting and analytics programs to generate insights and drive actions supporting Program Integrity and Fraud, Waste & Abuse (FWA ...
Fraud Waste Abuse Coding Auditor information
See salary details
$20.91 - $22.36
1% of jobs
$22.36 - $23.80
1% of jobs
$23.80 - $25.24
3% of jobs
$26.19 is the 25th percentile. Wages below this are outliers.
$25.24 - $26.68
30% of jobs
$26.68 - $28.13
7% of jobs
The median wage is $29.04 / hr.
$28.13 - $29.57
12% of jobs
$30.31 is the 75th percentile. Wages above this are outliers.
$29.57 - $31.01
40% of jobs
$31.01 - $32.45
1% of jobs
$32.45 - $33.89
1% of jobs
$33.89 - $35.34
1% of jobs
$35.34 - $36.78
2% of jobs
$20
$29
$36
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Fraud, Waste, and Abuse (FWA) Medical Record Reviewer
Elkridge, MD โข On-site
Other
Posted 25 days ago
Job description
Elite Technical is seeking a Fraud, Waste, and Abuse (FWA) Medical Record Reviewer! We are seeking an experienced healthcare fraud investigator and medical record reviewer with expertise in analyzing medical documentation, claims data, provider billing patterns, and regulatory compliance requirements. Skilled in identifying potential fraud, waste, and abuse indicators through detailed record review, coding validation, and investigative research. Knowledgeable in Medicare, Medicaid, HIPAA, CPT, HCPCS, and ICD-10 guidelines, with strong analytical and case documentation abilities.
<>Required SkillsEducation:
- Bachelor''s degree in:
* Health Information Management
* Nursing
* Healthcare Administration
* Medical Coding
* Criminal Justice
* Public Health
* Related healthcare field
- Experience
* 2-5+ years reviewing medical records, claims, or healthcare documentation. Experience in:
* Fraud, Waste, and Abuse investigations
* Medicare and Medicaid programs
* Claims auditing
* Utilization review
* Clinical documentation review
* SIU (Special Investigations Unit) operations
- Knowledge Requirements
* Medical terminology, anatomy, and physiology.
* CPT, HCPCS, and ICD-10 coding systems.
* Medicare, Medicaid, and commercial insurance regulations.
* Healthcare compliance requirements (HIPAA, OIG guidelines, CMS regulations).
* Documentation standards for healthcare providers.
- Technical Skills
* Electronic Medical Records (EMR/EHR) systems.
* Claims processing systems.
* Microsoft Office (Excel, Word, Outlook).
* Data analysis and reporting tools.
* Ability to identify documentation inconsistencies and billing irregularities.
- Certifications (Often Preferred)
* Certified Professional Coder (CPC)
* Certified Coding Specialist (CCS)
* Registered Health Information Technician (RHIT)
* Registered Health Information Administrator (RHIA)
* Certified Fraud Examiner (CFE)
* Accredited Healthcare Fraud Investigator (AHFI)
* Certified Professional Medical Auditor (CPMA)
- Key Competencies
* Strong analytical and critical-thinking skills.
* Attention to detail.
* Investigative mindset.
* Ability to interpret complex medical documentation.
* Report writing and case documentation skills.
* Knowledge of healthcare fraud schemes and abuse indicators.
About Elite Technical
Sourced by ZipRecruiter
Company size
51 - 200 Employees
Headquarters location
Ronkonkoma, NY, US
Year founded
1992