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Has any coder successfully transitioned from coding to do SIU (Fraud Waste and Abuse)? I would like to know how you made the change and what certifications would you need.
I have not personally done the switch to SIU, but I know the requirements of where I work, and of other coders who have done the jump.
Auditing experience is first and foremost in the front seat here. Depending on the employer, generally minimum 3-5 years is the standard I believe.
General coding certification (CPC/CCS) is usually required as well.
As far as a specific SIU certification goes, my best suggestion would be the CPMA. Many SIU folks I know enjoy that certification, and from what I hear it will help prepare you for a career in SIU. While I doubt this is a job requirement, it should be a boon and help set you apart from other applicants.
Thank you for your response. I was also looking at job postings and the fraud/Auditor Certification was the one I saw. The CPMA is good but it will be harder to maintain CEUs
I manage a Special Investigations Department currently with 8 certified coders doing prepayment review and assisting with investigations and audits. I have and likely will again hire individuals without a current coding certification but most of the positions require obtaining a certification within 24 months of hiring. I accept AAPC or AHIMA but if I hire someone who will need to work on a certification I support their pursuit of AAPC certification. All of my coders in addition to a corporate AAPC membership have access to the AAPC webinars for their ceus. CPC is the basic certification but like a previous response stated the CPMA is a great addition.
Good luck to you and if you are in Oklahoma I have a position open.
I currently work in SIU. I worked as a medical coder with a CPC for about 5 years which they saw as a significant amount of time. The interviewing process was a bit intense but it was all worth it in the end.
The interview process included a series of on the spot questions about a broad variety of coding question, a 25 question coding test and 2 follow up interviews. I was a medical assistant prior to becoming a medical coder so do not underestimate your overall background in the medical field as a valuable asset to the SIU or FWAE teams!