Special Investigations Unit Analyst

Job overview

The Special Investigations Unit Analyst role is remote eligible. The listing location is Chesterfield, MO. Compensation is not specified. Healthcare Fraud Shield provides healthcare fraud prevention and payment integrity solutions. The analyst supports investigations by reviewing medical records and claims, documenting findings, and helping prepare reports and data analyses. Careful handling of sensitive health information and coding details supports the team's fraud, waste, and abuse review work.

What you'll do

• Support daily SIU tasks and intake and triage of client-assigned work
• analyze patient medical records for fraud, waste, and abuse investigations
• compare records with claim information to determine billable services
• document claim-line findings and summarize results in reports
• abstract CPT, HCPCS, revenue, DRG, and ICD codes
• support coding-guideline knowledge and client-data analysis
• protect confidential information and comply with privacy and security standards.

What we're looking for

Skills & competencies

special investigations unit

siu analyst

healthcare fraud

payment integrity

medical records

claims analysis

cpt

hcpcs

icd-10

remote eligible

chesterfield mo

healthcare fraud shield

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental, and vision insurance
• 401(k) with employer match
• paid vacation and sick time
• paid holidays
• paid parental leave
• disability and life insurance
• FSA
• EAP
• professional development.

Why this role

No specific investigative experience is required; healthcare knowledge and interest in medical claims, coding, and investigations are a plus. Remote work requires high-speed internet with at least 25 Mbps download and 5 Mbps upload; satellite internet is not allowed.

About the employer

Healthcare Fraud Shield is hiring for this role. Industry: All Other Professional, Scientific, and Technical Services. Sector: 54.