Company

Molina HealthcareSee more

addressAddressLong Beach, CA
type Form of workFull-time
salary Salary$21.60 - $46.81 an hour
CategoryInformation Technology

Job description

JOB DESCRIPTION
Job Summary
Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations.
KNOWLEDGE/SKILLS/ABILITIES
Detects potential health care fraud, waste, and abuse through the identification of aberrant coding and/or billing patterns.
Performs medical record audits in order to validate coding accuracy.
Performs, as required, non-medical record review audits to validate billing accuracy.
Generates and provides accurate and timely written reports for internal and/external use detailing audit findings.
Renders provider coding education as appropriate based on coding guidelines, contractual, and/or regulatory requirements.
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experience
Required Experience
1-3 years
Required License, Certification, Association
Active and unrestricted coding certification (CPC or CCS).
Preferred Education
Bachelor's degree in health care related area.
Preferred Experience
3-5 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.6 - $46.81 / HOURLY

  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Benefits

Health insurance
Refer code: 8605612. Molina Healthcare - The previous day - 2024-03-17 04:38

Molina Healthcare

Long Beach, CA

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