Job description

We are looking to place a Medical Coding Specialist on a 5-year project with the Federal Government in Atlanta, GA. As a Medical Coding Specialist, your duties include researching medical coding evidence and documents, analyzing claims, and producing reports. Extensive experience in Current Procedural Terminology (CPT) codes & medical terminology required. Experience investigating health care fraud, grant fraud, procurement fraud, financial fraud preferred.

McNeal Professional Services, Inc. is a 21-year national Wireless Engineering and Staffing Services firm. We offer a comprehensive benefits package to include medical, dental, vision, STD, LTD and Life Insurance. Join our great team today!

If interested and available, please reply with an updated Word version of your resume and salary requirements.

Requirements:

• Extensive experience in Current Procedural Terminology (CPT) Codes & Medical Terminology.
• Nursing/medical background strongly preferred.
• Experience reviewing and analyzing large numbers of medical documents (e.g., over 20,000), identifying relevant documents and using the documents to assess the validity of allegations of wrongful conduct.
• Experience analyzing large amounts of data (e.g., claims data, financial data) in order to spot patterns, identify outliers, assess the validity of allegations of wrongful conduct and calculate losses or damages.
• Experience working with spreadsheets such as Excel and/or Access.
• Experience working with Microsoft PowerPoint or other presentation applications.
• Experience interviewing witnesses regarding fraud and other complex matters.
• Experience reviewing, tagging, and coding documents on a document review platform such as Relativity, Everlaw, IPRO Eclipse or Concordance.

Analytical Skills

• Independently plans and conducts investigative analysis of an extraordinary complex and difficult nature. Cases frequently concern exceptionally sensitive matters involving target organizations that are exceptionally complex in structure, such as those with a large number of primary and subsidiary activities.
• Investigations are of major interregional dimension, or are nationwide in coverage, with occasional international implications. Typical investigations of this nature are conducted in conjunction with federal, state and/or local agencies, both within and outside the client geographic jurisdiction.
• Works with assigned supervisor to determine applicable statutory and regulatory law and identifies possible violations.
• Independently pieces together evidence that comes from investigators, analysts, and law enforcement officers stationed throughout a large geographic area or several states. From this evidence, recognizes the subject’s pattern of operations in order to identify information of interest, anticipate events as they unfold, and/or by instructing separate investigators or auditors who are working on specific segments of the case. Determines proof required to assist in affixing legal responsibility for violation(s), and devises methods for obtaining, preserving, and presenting evidence for greatest litigative effect.
• Performs a variety of ancillary analytical and investigations-related services in direct support of litigation. Support activities include some or all of the following:
• Initiates contacts with federal, state, and local officials and other organizations and individuals related to the subject(s) of investigation for the purpose of gathering and analyzing facts, obtaining statements, learning sequences of events, obtaining explanations, and otherwise advancing investigative objectives.
• Examines books, ledgers, payroll, cost reports, billing statements, invoices, correspondence, computer data and other records pertaining to the transactions, events or allegations under investigation.
• Reviews and analyzes large numbers of documents produced by subjects of investigation and witnesses, identifies relevant documents, and uses the documents to assess the validity of allegations of wrongful conduct.
• Establishes and/or verifies relationships among all facts and evidence obtained or presented, to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary for successful litigation.
• Defines and conducts extensive research and analysis of data relating to suspected civil violations, such as health care fraud or other violations or offenses of special concern within the USAO community.
• Conducts witness interviews and prepares summaries of witness interviews.

Ability to pass a detailed, extensive federal background check and credit check.

Job Type: Full-time

Pay: $72,543.00 - $86,260.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

COVID-19 considerations:
Wear mask as necessary.

Work Location: One location

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