Senior FWA Investigator, Healthcare Claims Analytics
Hispanic Alliance for Career Enhancement
Hispanic Alliance for Career Enhancement is looking for a Sr. Analyst, Fraud, Waste, and Abuse to assist in investigations and referrals of FWA incidents related to healthcare services. This role requires strong analytical skills and knowledge of coding guidelines. With responsibilities such as reviewing claims data and identifying patterns, you will ensure compliance and support the team's mission of improving healthcare experiences for individuals and communities. 75 hours/week, full-time position. Benefits include medical, dental, vision coverage, and more. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Senior FWA Investigator, Healthcare Claims Analytics in New York, NY vacancy
$46.99k - $112.2k
...Abuse. This full-time position involves reviewing claims and investigating FWA incidents across healthcare services. Candidates should have 3-5 years of experience, a coding certification (CPC), and strong analytical skills. The role offers a competitive salary ranging...SeniorClaimsFull time- ...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
$46.99k - $112.2k
...looking for a Sr. Analyst, Fraud, Waste, and Abuse (FWA) in Idaho. This role involves reviewing claims data to identify potential fraud patterns, collaborating with regulatory agencies, and conducting investigations. Qualified candidates should have 3-5 years of relevant...SeniorClaims$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
- 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$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- Molina Healthcare in the United States seeks an investigator to support the SIU's medical provider coding fraud investigations... ...will re-evaluate post-payment claims against records, review CPT... ...CPMA or AAPC certification, strong analytical and communication skills, and proficiency...Claims
- CVS Health is seeking a Sr. Analyst, Fraud, Waste, and Abuse (FWA) to detect and remediate incidents across healthcare services, reviewing billing data and coding accuracy to prevent improper payments. You will work with Compliance, Legal, and Provider Relations, triage...SeniorFull time
$68.04k - $118.8k
...Summary of Job Conduct complex, in-depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain relationships with... ...sources to review for suspect activity. Review claim files and develop action plans for the...SeniorClaimsWork experience placementEmblemHealth
New York, NY1 day ago- ProcDNA, a leader in life sciences consulting in New Jersey, is seeking a Sr Analyst - Analytics. The ideal candidate will have strong expertise in claims-based analytics, advanced knowledge in tools like Tableau, SAS, R, and Alteryx, and a passion for the pharmaceutical...SeniorClaims
- 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
$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- EmblemHealth is seeking a seasoned fraud investigator to conduct complex investigations into Medicaid fraud, develop leads, review claim files, and guide junior investigators. You will interview providers, assess medical records, and ensure accurate CPT coding while mentoring...SeniorClaims
- ...ultimately trickles down across the healthcare ecosystem, driving up costs... .... Alaffia is a new kind of claims operations partner for... ...charge to build the data and analytics foundation of how Alffia... ...builds, one-off analyses, and investigations into anomalies or unexpected...SeniorClaimsVisa sponsorshipWork visa
Alaffia Health
New York, NY3 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- ...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, NY16 days ago $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- ...execution of standard and ad‑hoc analytics to identify/quantify payer... ...knowledge. Identify through claims analysis and market research,... ...good understanding of the U.S. healthcare landscape and key AbbVie... ...Marketing stakeholders. The Senior Manager, Analytics - Emerging...SeniorClaims
$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$60 - $65 per hour
...Title- EEO Investigator location - New York, NY Duration - 06/... ...of discrimination, including claims of sexual harassment, while... ...be able to report to various healthcare facilities throughout New York... ...skills Strong analytical and communication skills required...ClaimsLocal areaShift workIntegrated Resources
New York, NY1 day ago- MDD in Minneapolis seeks a Senior Accountant to support the accounting team at our Minneapolis office... ...accounting/finance, strong communication, and analytical skills, with the ability to work independently on complex claims and financial analyses. The ideal candidate...SeniorClaimsWork at office
- ...New York is seeking an experienced ACE Investigator to assist with federal fraud investigations... ...knowledge of investigative techniques, analytical skills, and proficiency with various... ...support the investigation of fraud in healthcare, contracting, and grants. Competitive benefits...Senior
- Index Analytics is seeking a Senior Investigator for a full-time remote position focused on compliance investigations into healthcare providers. This role involves managing research, analysis, and reporting on regulatory adherence while also mentoring junior staff and collaborating...SeniorRemote jobFull timeWork experience placement
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
- employee relations investigator New York, NY
- insurance investigator New York, NY
- asset protection investigator New York, NY
- case investigator New York, NY
- security investigator New York, NY
- federal background investigator New York, NY
- lead investigator New York, NY
- compliance investigator New York, NY
- legal investigator New York, NY
- accident investigator New York, NY