Job Details

Analyst Coding - Claims Investigator

Company name
Molina Healthcare, Inc.

Location
Syracuse, NY, United States

Employment Type
Full-Time

Industry
Insurance, Healthcare

Posted on
Mar 11,2019

Valid Through
Jun 24,2019

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Profile

Analyst, Coding - Claims Investigator','1900611','US-NY-Syracuse-NYCLAY','','Legal, Risk, & Compliance','Health Plans','','Mar 11, 2019','!*!Molina Healthcare of NY is looking for candidates with the following qualifications:

Candidate's with prior experience in cost containment, Special Investigation, Fraud, Waste and Abuse.

3 to 5 years of experience in Medical Billing and Coding.

Capable to work on a Matrix Environment.

3 to 5 years of experience on Claims review recovery, Claims disputes from providers.

We are looking for self motivated team players with knowledge in Excel.

To learn more about Molina Healthcare Careers, follow us on LinkedIn, Twitter & Facebook. You can also visit Molina Cares to view interactive tutorials on resume & cover letter writing, interviewing and more!','!*!Molina Healthcare of NY is looking for candidates with the following qualifications:

Candidate's with prior experience in cost containment, Special Investigation, Fraud, Waste and Abuse.

3 to 5 years of experience in Medical Billing and Coding.

Capable to work on a Matrix Environment.

3 to 5 years of experience on Claims review recovery, Claims disputes from providers.

We are looking for self motivated team players with knowledge in Excel.

To learn more about Molina Healthcare Careers, follow us on LinkedIn, Twitter & Facebook. You can also visit Molina Cares to view interactive tutorials on resume & cover letter writing, interviewing and more!','!*!

Job DescriptionJob SummaryEstablish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations.Knowledge/Skills/Abilities• Detects potential health care fraud, waste, and abuse through the identification of aberrant coding and/or billing patterns.• Performs medical record audits in order to validate coding accuracy.• Performs, as required, non-medical record review audits to validate billing accuracy.• Generates and provides accurate and timely written reports for internal and/external use detailing audit findings.• Renders provider coding education as appropriate based on coding guidelines, contractual, and/or regulatory requirements.','!*!

Job QualificationsRequired EducationAssociate's Degree or equivalent combination of education and experienceRequired Experience1-3 yearsRequired License, Certification, AssociationCurrent coding certification (CPC or CCS).Preferred EducationBachelor's degree in health care related area.Preferred Experience3-5 yearsTo all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.','Analyst, Coding - Claims Investigator

Company info

Molina Healthcare, Inc.
Website : http://www.molinahealthcare.com

Company Profile
Molina Healthcare, a FORTUNE 500, multi-state health care organization, arranges for the delivery of health care services and offers health information management solutions to nearly five million individuals and families who receive their care through Medicaid, Medicare and other government-funded programs in fifteen states.

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