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Data Analyst Fraud Waste & Abuse

RIT Solutions

Data Analyst Fraud Waste & AbuseThe Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You will be working with a State Government Product and Data Mining team. Your primary responsibility will be to assist in the development and deployment of algorithms designed to support program integrity across various platforms and states plus support our fraud and abuse detection product and services. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:3+ years experience writing intermediate SQL queries3+ years fraud, waste and abuse data mining experience2+ year data analysis experience working with database structures2+ years of healthcare claims experiencePreferred Qualifications:Industry certifications: Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE)Experience with statistical analysis of dataKnowledge of Medicaid policy and real-life fraud, waste, abuse schemesKnowledge of healthcare claim adjudication systemsExperience with Rally

Vacancy posted 19 hours ago
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