Coding Investigator Auditor - Oklahoma

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary: This position is responsible for performing 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. The individual in this role will also be conducting research; preparing documentation of findings and consulting with medical directors as needed. Additional duties include coordination with all departments involved in each case required such as special investigations, customer service, pass, network management, marketing, case management, medical review, legal, pricing and database. Required Job Qualifications: Bachelor Degree; one year of business experience, law enforcement experience, or regulatory agency experience may substitute for each year of college. Certified Coding Certification, or acquire within 24 months...