Summary
Molina Healthcare is seeking a skilled investigator specializing in medical provider coding fraud, waste, and abuse (FWA) within the SIU. You will re-evaluate claims using CPT coding knowledge and applicable federal/state regulations, reviewing post-pay claims against records to ensure payment accuracy.Responsibilities include prioritizing caseloads, preparing clinical summaries, and supporting investigations for potential referrals or recovery, with emphasis on compliance and collaboration in#J-18808-Ljbffr
Job Description
Molina Healthcare is seeking a skilled investigator specializing in medical provider coding fraud, waste, and abuse (FWA) within the SIU. You will re-evaluate claims using CPT coding knowledge and applicable federal/state regulations, reviewing post-pay claims against records to ensure payment accuracy.Responsibilities include prioritizing caseloads, preparing clinical summaries, and supporting investigations for potential referrals or recovery, with emphasis on compliance and collaboration in#J-18808-Ljbffr
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