Remote Otter LogoRemoteOtter

Special Investigation Unit (SIU) Coding Review Manager - Remote

Posted 2 weeks ago
All others
Full Time
USA
$54,300.00 - $159,120.00/year

Overview

The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record reviews for medical, behavioral, transportation, and other healthcare providers.

In Short

  • Lead and mentor a team of CPCs in coding practices and medical record reviews.
  • Conduct regular audits of team performance to ensure compliance with coding standards.
  • Establish team goals and monitor performance.
  • Direct complex coding reviews and resolve intricate issues.
  • Ensure detailed written summaries of medical record review findings.
  • Conduct team member evaluations and provide performance feedback.
  • Collaborate with Medical Directors on complex cases.
  • Assist with investigative research related to coding questions.
  • Maintain appropriate records and documentation for the team.
  • Develop and implement training programs for new team members.

Requirements

  • A minimum of 2 years of managing a staff.
  • Coding Certification (CPC, CPMA, COC).
  • A minimum of 5 years of experience in medical record review.
  • Strong knowledge of industry coding guides and guidelines.
  • Proficiency in Microsoft Excel and Word.
  • Strong attention to detail and ability to interpret data.
  • Demonstrates strong communication and leadership skills.
  • Preferred: 2 years of managing staff within a SIU.
  • Preferred: Registered Nurse (RN).
  • Preferred: Experience with Behavioral Health coding.

Benefits

  • Affordable medical plan options.
  • 401(k) plan with company matching.
  • No-cost wellness programs.
  • Flexible work schedules.
  • Tuition assistance and dependent care resources.
  • Confidential counseling and financial coaching.
  • Paid time off and family leave.
  • Employee stock purchase plan.
  • Retiree medical access.
  • Comprehensive benefits tailored to employee needs.

A.R

Aetna Resources

Aetna Resources, a part of CVS Health, is a leading health solutions company dedicated to transforming healthcare for millions of Americans. With a workforce of over 300,000 passionate colleagues, Aetna focuses on providing connected, convenient, and compassionate care through various channels. The company emphasizes data intelligence to support its Medicare organization and Stars program, aiming to enhance member experiences and elevate Star ratings while adhering to regulatory guidelines. Aetna is committed to fostering a diverse and inclusive workplace, offering comprehensive benefits and a culture that values collaboration, trust, and innovation.

Share This Job!

Save This Job!

Similar Jobs:

O.H

Investigations Manager, Special Investigations Unit (SIU) - Remote

Oscar Health

24 weeks ago

Oscar is seeking an Investigations Manager for their Special Investigations Unit to lead anti-fraud initiatives and manage a team.

USA
Full-time
All others
$88,560 - $116,235/year

E.R.S

Special Investigations Unit (SIU) Manager - Remote

Ethos Risk Services

31 weeks ago

Ethos Risk Services is seeking a full-time remote Special Investigations Unit (SIU) Manager to conduct investigations in property and casualty insurance claims.

TX, USA
Full-time
All others

M.T.A

Special Investigation Unit (SIU) Investigator - Remote

Molina Talent Acquisition

24 weeks ago

The SIU Investigator is responsible for investigating health care fraud, waste, and abuse through audits and data analysis.

USA
Full-time
All others

M.T.A

Special Investigation Unit (SIU) Investigator - Remote

Molina Talent Acquisition

24 weeks ago

The SIU Investigator is responsible for investigating health care fraud, waste, and abuse through audits and data analysis.

NY, USA
Full-time
All others

C.R

Manager, Special Investigations Unit - Pharmacy Investigations - Remote

Capital Rx

10 weeks ago

The Manager of the Special Investigations Unit will lead efforts to oversee and enhance the Fraud, Waste, and Abuse program within the healthcare sector.

Worldwide
Full-time
All others
$100,000 - $135,000/year