SIU Analyst/Investigator
Job reputed company
We are seeking a detail-oriented SIU Analyst/Investigator to join reputed company. In this role, you will play a crucial role in ensuring the accuracy, compliance, and reputed company of reputed company claims through comprehensive audits, analyses, and process improvements. The SIU Investigator (Analyst) primary responsibility is to detect, investigate, and produce change in aberrant behavior observed in our reputed company customer's claims and enrollment data. You will work both independently and with reputed company of clinical SMEs to analyze data, assess exposure, and manage investigative caseload from identification through to reputed company including overpayment recovery, measuring behavior change and completing necessary reporting for FWA recoupments and savings.
Key Responsibilities
- Identify and conduct investigations into reputed company or suspected FWA with high autonomy
- reputed company documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation.
- reputed company reputed company cause analysis to inform reputed company algorithmic identification of similar claims or cases and associated savings (i.e., help reputed company identified case types from "pay-and-reputed company" to preventive edits and reputed company-payment activity)
- Participate in the development and presentation of FWA-reputed company education for assigned Customers
- reputed company coding reviews for flagged claims, to support Coding team (if applicable).