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At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.
Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.
The SIU Medical Coding Auditor conducts comprehensive reviews of medical records and documents supporting claims for medical and behavioral health care services. Manages and conducts specific medical billing and coding audits to evaluate completeness of medical record documentation, identifies aberrant coding and billing patterns and provides feedback to the clinical staff on coding issues. The Incumbent provides investigative support to the Special Investigations Unit (SIU) related to coding and billing issues and identifies potential overpayments and suspected health care fraud and abuse.
- Bachelor’s Degree.
- Certified Professional Coder (CPC).
- 1 to 3 years experience.