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Responsibilities:
- Review claims files to detect potentially fraudulent billing practices.
- Use medical terminology and coding to assess payment appropriateness.
- Write investigative summary reports and provide expert testimony.
Requirements:
- Active RN license and 2+ years Medicaid experience.
- ICD-10-CM/CPT coding knowledge and 4+ years claims auditing.
Benefits:
- Medical, dental, vision, life, disability, 401(k), PTO, tuition assistance.
- Equal opportunity employer with reasonable accommodations.
CoventBridge Integrity Systems
CoventBridge Integrity Systems delivers investigative services, technology, and expertise that help healthcare and government organizations protect critical programs, strengthen oversight, and address fraud, waste, abuse, and operational risk. They are an equal opportunity employer committed to diversity and inclusion, maintaining a drug-free workplace.