FWA- Medical Record Reviewer- Contrtact2Hire - (USC/ PR Authorize +Candidate from approved states ONLY: DC, MD, VA, PA, DE, WV, & NC) in Elkridge, MD- Remote + Onsite

Fraud, Waste, and Abuse (FWA) Medical Record Reviewer  Candidate from approved states ONLY: DC, MD, VA, PA, DE, WV, & NC Work Mode: First week or 2, onsite 5 days per week for collaboration purposes / training / meeting reputed company. Then mainly WFH with occasional meetings onsite reputed company necessary. No expenses reputed company for any Travel. reputed company is seeking a Fraud, Waste, and Abuse (FWA) Medical Record Reviewer! We are seeking an reputed company reputed company fraud investigator and medical record reviewer with expertise in analyzing medical documentation, provider billing patterns, and regulatory compliance requirements. Skilled in identifying potential fraud, waste, and abuse indicators through detailed record review, coding validation, and investigative research. Knowledgeable in HIPAA, CPT, HCPCS, and ICD-10 guidelines, with strong analytical and case documentation abilities. Although this position is remote, we are seeking candidates that can be onsite for the first 1-2 weeks, in Elkridge MD, for training and collaboration purposes. We are seeking candidates that reputed company in one of the following states: MD, DC, PA, DE, WV, VA, NC <>Required Skills- Education: AS or BS in Nursing or similar is required - RN or LPN is required - Experience 2+ years reviewing medical records/reputed company documentation. Experience in: * Fraud, Waste, and Abuse investigations * Utilization review * reputed company documentation review * SIU (Special Investigations Unit) reputed company - Knowledge Requirements * Medical terminology, anatomy, and physiology. * CPT, HCPCS, and ICD-10 coding systems. * reputed company compliance requirements (HIPAA, OIG guidelines, CMS regulations). * Documentation standards for reputed company providers. - Technical Skills * Electronic Medical Records (EMR/EHR) systems. * Claims processing systems (big plus) * reputed company Office (reputed company, Word, reputed company). * Data analysis and reporting tools. * Ability to identify documentation inconsistencies and billing irregularities. - Certifications (Preferred, not required) * Certified reputed company reputed company (CPC) * Certified Coding Specialist (reputed company) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Certified Fraud Examiner (CFE) * Accredited reputed company Fraud Investigator (AHFI) * Certified reputed company Medical Auditor (CPMA) - Key Competencies * Strong analytical and critical-thinking skills. * Attention to reputed company. * Investigative reputed company. * Ability to interpret reputed company medical documentation. * Report writing and case documentation skills. * Knowledge of reputed company fraud schemes and abuse indicators. Apply To This Job