Senior FWA Investigator, Healthcare Claims Analytics
Hispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement seeks a Sr. Analyst, Fraud, Waste, and Abuse to support the detection and investigation of healthcare fraud. The role emphasizes strong analytical skills and experience with coding guidelines. Key responsibilities include reviewing claims data, conducting investigations, and collaborating with various departments to ensure compliance. Candidates should have at least 3-5 years of relevant experience and a coding certification. A comprehensive benefits package is provided for this full-time position. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Senior FWA Investigator, Healthcare Claims Analytics in Brooklyn, NY vacancy
- ...specializing in Fraud, Waste, and Abuse in healthcare. The role involves detecting and investigating potential fraud and ensuring... ...5 years of relevant experience, analytical skills, and a coding... ...Responsibilities include reviewing claims data, assisting with investigations...SeniorClaims
- ...Alliance for Career Enhancement is looking for a Sr. Analyst focused on Fraud, Waste, and Abuse (FWA) in Oklahoma. This role involves reviewing claims data, investigating FWA complaints, and ensuring compliance with regulatory standards. The ideal candidate has 3-5 years...SeniorClaimsFull time
$70k - $90k
Senior Investigator - Pre-Pay (Healthcare FWA) Job Location: US-Remote Overview As a Senior Investigator, you will investigate suspected incidents... ...may warrant further investigation. Utilizes data analytics, claims review, and industry intelligence to detect potential...SeniorClaimsWork experience placementWork at officeRemote workWork from home$70k - $90k
A leading healthcare analytics firm is seeking a Senior Investigator to investigate incidents of healthcare fraud, waste, and abuse through data analysis. This remote... ...'s degree, 5-8 years of experience in healthcare FWA investigations, and advanced Excel skills....SeniorRemote job$60.2k - $107.4k
A leading health care organization is looking for a Senior Investigator Pharmacy to tackle healthcare fraud, waste, and abuse. The role includes investigating... ...with relevant experience, and knowledge of pharmacy claims processing is preferred. The position requires up to...SeniorClaims- ...complex cases involving health care fraud. The candidate will investigate claims, collaborate with law enforcement, and ensure adherence to... ...years of relevant experience in fraud investigations. Strong analytical skills and proficiency with Microsoft Office are essential...SeniorClaimsFull timeWork at office
$130k - $170k
Smith Hanley Associates is seeking a skilled healthcare actuarial professional in New York. This role focuses on Medicare claims analytics and value-based care, supporting actuarial initiatives aimed at enhanced client success. Ideal candidates will have 3-5 years of experience...SeniorClaims$46.99k - $122.4k
...for Career Enhancement is hiring for a position focused on investigating healthcare fraud cases. The ideal candidate will have a Bachelor’s degree... ...include handling complex cases, preventing fraudulent claims, and interacting with various stakeholders. This full-time...SeniorClaimsFull time- Centene Management Company LLC is seeking a skilled investigator to handle allegations of healthcare fraud and abuse in New York. In this role, you'll plan, organize, and execute claims investigations, utilizing your expertise in data mining and report creation. The ideal...SeniorClaimsRemote jobFlexible hours
- ...leaders, sophisticated data analytics and research, and... ...visit: . As a Senior Associate of Analytics... ...update Morgan Health's healthcare data model (e.g., marts... ...standards. Proactively investigate, identify root causes,... ...and pharmaceutical claims, eligibility, provider...SeniorClaimsVisa sponsorship
J.P. Morgan
New York, NY10 days ago $106.61k - $284.28k
...0 Position Summary Our client, a Fortune 500 healthcare company, is hiring a Senior Product Manager within their Analytics & Behavior Change (A&B) organization. You will... ...sciences Familiarity with medical and pharmacy claims data and their use in healthcare analytics...SeniorClaims$60.2k - $107.4k
Senior Investigator Pharmacy At UnitedHealthcare, we're simplifying the health... ...investigation and prevention of healthcare fraud, waste and abuse. The investigator will use claims data, applicable guidelines... ..., fraud, waste and abuse (FWA) 2+ years of experience in state...SeniorClaimsFull timeTemporary workWork experience placementLocal areaRemote work$70k - $90k
Cotiviti is seeking a Senior Investigator to analyze suspected incidents of healthcare fraud, waste, or abuse through data analysis. The role involves evaluating instances of potential fraud and conducting interviews with patients and providers. Candidates should have...SeniorRemote jobWork from home$130k - $200k
...130,000.00 To $200,000.00 Annually The Opportunity As a Healthcare Data Analytics Senior, you will be an experienced professional in health data management... ...audiences. They will support teams in applying CMS claims and enrollment data, analytics platforms, statistical...SeniorClaimsFull timeFor contractorsFlexible hours$67.9k - $199.14k
...an exciting opportunity for a Senior Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will... ...analytics, interpreting large healthcare datasets, and translating... ...leveraging medical and pharmacy claims, encounter, provider, and membership...SeniorClaimsRemote jobHourly payFull timeTemporary workWork experience placementLocal area- Responsibilities Conducts investigations into allegations of fraud, waste... ...analyzes medical records, claims data, enrollment data, and other... ...to evaluate potential FWA. Performs coding, billing, reimbursement... ...Coder (CPC), Accredited Healthcare Fraud Investigator (AFHI),...SeniorClaimsWork at office
$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$46.99k - $112.2k
...time. Position Summary As a Senior Investigator you will conduct high level... ...known or suspected acts of healthcare fraud and abuse. Routinely... ...payment of fraudulent claims submitted to the Medicaid lines... ...in any situation. Strong analytical and research skills. Proficient...SeniorClaimsHourly payFull timeTemporary workWork at officeLocal area$83.1k - $120.36k
The Senior Analyst, Audit and Compliance Analytics leverages healthcare data, analytical tools, and business knowledge to support Internal Audit, Compliance Analytics, and Claims Configuration Audit initiatives. This role partners with cross-functional teams to identify...SeniorClaimsFull timeTemporary workWork experience placement$46.99k - $122.4k
CVS Health is looking for a skilled individual to manage healthcare fraud investigations in New Jersey. The role entails handling complex cases,... ...with essential experience in healthcare fraud and strong analytical skills. This full-time position includes competitive pay...SeniorFull time- ...individual skilled in medical coding and claims analysis to uncover third-party liability (TPL) in healthcare claims. Your work will directly... ...solid understanding of ICD-10, proven analytical skills, and a passion for investigative work at the intersection of healthcare...Claims
- Gainwell Technologies is seeking a Senior Business Analyst - Benefit Plan Administration to improve health and... ...experience with Medicaid and Medicare, focusing on claims and benefits. The role requires solid analytical skills and involves leading a team in a fast-paced...SeniorClaimsRemote job
$18 per hour
...A leading healthcare provider is hiring a Senior Claims Examiner to work from home, ensuring accurate adjudication of complex claims for SCCIPA contracted... ...offers a base pay of $18.00 per hour and emphasizes strong communication and analytical skills. #J-18808-Ljbffr...SeniorClaimsHourly payFull timeRemote workWork from homeBroadpath Inc
New York, NY22 hours ago$101.97k - $222.48k
...the data science department ("Analytics & Behavior Change"), you'll... ...quality at a leading national healthcare brand. We're looking for data... .... This is a hands‑on Senior data scientist role, with a combination... ...of adjudicated prescription claims and member level records...SeniorClaimsHourly payFull timeTemporary workWork experience placementInternshipLocal area$120k - $150k
...Title Senior Analyst - Accounting & Healthcare Reimbursement Compensation ~ $120,00... ...professional growth Strategic, analytical responsibilities at the intersection... ...Oversee reconciliation of claims, payments, and final settlements-producing...SeniorClaimsLocal areaMonday to FridayCreative Financial Staffing
New York, NY1 day ago$40 - $60 per hour
A healthcare solutions provider is seeking an experienced individual with strong QNXT configuration skills... ...QNXT functionalities such as Membership and Claim Processing. The ideal candidate will work independently, have analytical skills, and contribute to building healthcare...SeniorClaimsHourly pay- Highmark Health is seeking a senior leader to manage a team of actuarial and analytics professionals. This role will guide strategic initiatives in claims reserving and financial forecasting,... ...have over 7 years of experience in healthcare, strong leadership skills, and a...SeniorClaims
- ...support fraud detection and investigations in the Special Investigations... ...review medical records and claims, conduct audits, and collaborate... ...This role emphasizes strong analytical skills, communication, and... ...in handling sensitive healthcare information. #J-18808-Ljbffr...Claims
$120k - $150k
DW Simpson Global Actuarial & Analytics Recruitment is actively seeking two Actuarial Analysts to support a healthcare client in New York. These analysts will play a crucial role... ...experience, particularly with Medicare claims data and Value Based Care. The ideal applicants...SeniorClaims$122k - $162.7k
Overview Join AIR as a Senior Researcher with our Healthcare Innovations team. Our team... ...roles such as principal investigator, project director, or task... ...questions, methodologies, and analytic plans. Apply subject-... .... Experience analyzing claims and other large or complex...SeniorClaimsFull timeContract workFixed term contractH1bWork at officeRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior FWA Investigator, Healthcare Claims Analytics. Be the first to apply!
Related searches
- investigator Brooklyn, NY
- case investigator Brooklyn, NY
- forensic investigator Brooklyn, NY
- background investigator Brooklyn, NY
- human rights investigator Brooklyn, NY
- aml investigator Brooklyn, NY
- healthcare investigator Brooklyn, NY
- employee relations investigator Brooklyn, NY
- insurance investigator Brooklyn, NY
- credit investigator Brooklyn, NY