Senior FWA Investigator, Healthcare Claims Analytics
$46.99k - $112.2kHispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement is seeking a Sr. Analyst, Fraud, Waste, and Abuse (FWA) to assist in detecting and investigating incidents of fraud in healthcare services. This role requires a strong analytical background and knowledge of coding standards. Candidates should have 3-5 years of work experience, a CPC certification, and experience in reviewing healthcare claims. The position is full-time with a competitive salary range of $46,988-$112,200. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
- ...qualified candidate for a position focused on investigating health care fraud. Responsibilities... ...complex cases, preventing fraudulent claims, and documenting activities diligently.... ...at least three years of experience in healthcare fraud and a Bachelor's degree, emphasizing...SeniorClaimsFull time
$46.99k - $122.4k
...groups in a prepayment environment Investigates to prevent payment of fraudulent claims committed by insured's,... ...investigation and prosecution of healthcare fraud and abuse matters. Demonstrates... ...Health fraud cases. Strong analytical and research skills using health...SeniorClaimsHourly payFull timeTemporary workLocal area- ...never been. We’re rebuilding how healthcare works by bringing the impact... ...About theSenior Director of Analytics We are hiring a... ...hold a high bar. Work with senior leadership to turn company strategy... ...are a plus. Experience with claims or value-based care analytics...SeniorClaimsTemporary workDay shift
$84.4k - $152.3k
...company that will invest in your professional development. The Healthcare Senior Analytics Consultant will lead the development of technical and... ...Adherence measures, CMS pharmacy data, pharmacy and provider claims. Experience with advanced analytics tools/languages such...SeniorClaims$78.32k - $128.16k
...Investigator II Hybrid 1: This role requires associates to be in-office... ...against perpetrators of healthcare fraud in order to recover corporate... ...funds paid on fraudulent claims. How you will make an... ...May interface internally with Senior level management and legal department...ClaimsTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week$23.16 - $35.88 per hour
A leading healthcare organization is seeking a skilled professional to manage Stop Loss claims in Nashville, TN. This role involves evaluating and processing claims, building positive client relationships, and ensuring adherence to standards. Candidates should have 5 years...SeniorClaimsHourly pay- BlueCross BlueShield of Tennessee is looking for an Investigator II for its Special Investigations Unit. The position involves conducting... .... Ideal candidates should have 8 years of experience in healthcare fraud investigations and a Bachelor’s Degree or equivalent experience...SeniorRemote job
- A major health services provider seeks a Healthcare Senior Analytics Consultant in Nashville, TN. The ideal candidate will lead enhancements to Medicare Part D Star ratings through advanced reporting and analytics. Responsibilities include designing dynamic dashboards,...Senior
$86.3k - $118.7k
...our caring community The Senior Compliance Professional ensures... ...lines to enhance data analytics and operational improvement efforts... ...in pharmacy operations and/or claims processing within a pharmacy... ...personal wellness and smart healthcare decisions for you and your family...SeniorClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$91.4k - $187k
...Oracle Health is transforming healthcare through intelligent,... ...seeking a highly motivated Senior Product Manager to lead product... .... ~ Experience using data, analytics, customer insights, and KPIs... ...Experience with prior authorization, claims management, eligibility...SeniorClaimsTemporary workWorldwideFlexible hours- ...Senior Full Stack Software Developer Anywhere Type: Contract... ...: Development Industry: Healthcare Workplace Type: Remote... ...involving cases, documents, and claims. Due to client... ...transaction systems. Strong analytical, verbal, and written communication...SeniorClaimsHourly payContract workLocal areaRemote work
- HCA Healthcare is seeking an Insurance Manager to play a vital role in their Risk & Insurance department. This position involves analyzing... ...the Insurance Operations segment. Responsibilities include claims analysis, insurance renewals, communication with brokers, and contract...SeniorClaimsContract work
$67.9k - $199.14k
CVS Health is seeking a Senior Informatics Manager to lead data-driven analytics for its Risk Adjustment Analytics team. The role involves managing a small team... .... Ideal candidates will have over 8 years in healthcare analytics, leadership experience, and strong technical...Senior- HCA Healthcare in Nashville, Tennessee, is seeking a Senior Leadership and Org Development Coordinator. This role supports the Leadership & Organizational Development... ...data-driven insights through reporting and analytics. Responsibilities include building reports, analyzing...Senior
- Ardent Health is seeking a Senior Operations Reporting Analyst based in Brentwood, Tennessee... ...designing, developing, and delivering analytical solutions that enhance strategic... ...ideal candidate will have a background in healthcare analytics with over 5 years of experience...Senior
$94.3k - $109.5k
...make a meaningful impact in healthcare. The challenges of healthcare... ...everyone, now and into the future. Senior Strategic Finance Analyst The... ...with financial and analytical support. In this role, you will... ...Actuarial team to interpret claims data, identify cost drivers,...SeniorClaimsTemporary work- ...consulting services, project management, and analytical business resources in the health care... ..., specifically a HealthRules Payer claims system Implementation/Migration. Proven... ...leaders, and team members from across the healthcare organization. Proficiency with MS Office...SeniorClaimsFull timeLive outRemote workFlexible hours
- Description The healthcare system isn't designed for health. We're... ...Wellvana is seeking an experienced Analytics Engineer to help build and... ..., and work directly with claims and provider data across a... ...external partners and vendors Investigate and resolve data anomalies...ClaimsShift work
- ...Medical Management Clinician Senior Location: This role enables associates to work... ...medical policies. May collaborate with healthcare providers. Focuses on relatively complex... ...Capabilities, and Experiences: Prior claims experience is strongly preferred. Utilization...SeniorClaimsFull timeContract work
- ...Health is a leading provider of healthcare in growing mid‑sized urban... ...states. POSITION SUMMARY: The Senior Operations Reporting Analyst... ..., and delivery of advanced analytics and reporting solutions that... ...systems such as Epic, Cerner; claims data). Advanced Excel skills...SeniorClaims
$45k - $52.5k
...personalization, behavioral healthcare can leave people feeling unseen... ...and timely insurance claim submission for our Intensive... ...demands a detail-oriented, analytical professional who understands... ...claims for potential errors Investigate escalated insurance billing...ClaimsFull timeTemporary workWork at officeLocal area$60k - $120k
Base pay range: $60,000.00/yr - $120,000.00/yr Seniority level Mid‑Senior level Employment type Full-time Job function... ...with cross‑functional teams to integrate and process healthcare datasets, including claims, EHR, and payer‑provider data Implement CI/CD pipelines...SeniorClaimsFull timeWork at officeRemote workMonday to FridayFlexible hours$70.35k - $205.8k
...fastest growing areas of our business, and our global Cyber Investigation and Forensic Response (CIFR) practice is at the heart of how... ...Active Directory, and common attack patterns Project management, analytical, and client‑facing communication skills Solving complex...SeniorWork experience placementLive inWork at officeLocal area$46.99k - $112.2k
...Fraud, Waste, and Abuse (FWA) will assist in detecting, investigating, remediating and... ...transportation, and other healthcare services. The Sr. Analyst... ...correct coding, review claims, and billing data from all... ...Responsibilities Leverage analytical skills to review claims...SeniorClaimsHourly payFull timeTemporary workWork experience placementLocal area$67.9k - $199.14k
...Health is seeking an experienced individual to lead the Claims Workforce Management team in Nashville, Tennessee. This role... ...of experience in workforce management or operational analytics, ideally in healthcare or insurance contexts. The position offers a competitive...SeniorClaims- HCA Healthcare in Nashville, TN, is seeking a skilled Sr. Cost Analyst to analyze healthcare supply chain spending. You will play an integral role in developing tools and reports that identify cost-savings opportunities while collaborating with team members and stakeholders...Senior
$150.03k - $224.25k
...of Clinical Management, the Senior Clinical Study Manager is responsible... ...IRB, IVRS, etc.), and investigative sites. • Provide... ...communication, organization, planning, analytical, problem solving, and people... ...processing fee, even if claimed you will be reimbursed, this...SeniorClaimsContract workTemporary workLocal areaFlexible hours$184.8k - $254.1k
...community The Director of Claims Analytics & Analysis will lead a high... ...analytics function focused ondeep investigative analysis of claims... ...and operationally fluent in healthcare claims — someone who instinctively... .... Deliver effective senior executive level communication...ClaimsFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome office$85k - $100k
A leading healthcare organization is looking for a Senior Energy Analyst to analyze energy data and track carbon emissions. This role involves collaborating with diverse teams to support sustainability initiatives and improve operational efficiency. The ideal candidate...Senior- Crains Cleveland is seeking a Senior Manager, Claims Services to lead a talented team in Nashville, TN. This role involves overseeing claims... ...have extensive experience in claims management, exceptional analytical abilities, and proficiency in Microsoft tools. The position...SeniorClaims
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