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Clinical Provider Auditor II
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Full-time
- Job Description :Clinical Provider Auditor IISupports the Payment Integrity line of businessLocation: This position will work a hybrid model (remote and office).
- Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.
- 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.
- Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.
- Minimum RequirementsRequires a AA/AS and minimum of 4 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.
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