Fraud Analyst
Virtual Vocations Inc
Proactively identifying instances of fraud, waste, and abuse, the full-time Senior Fraud Analyst will analyze medical billing data and collaborate with engineering and data science teams to enhance anomaly detection algorithms in a remote work environment. Key responsibilities Identify potential instances of fraud, waste, and abuse through data analysis Support engineering and data science teams with audit and FWA concepts and data mapping Validate and tune anomaly detection algorithms based on real-life experience Required qualifications Hands-on experience with medical billing errors and fraud analysis using analytic and SQL/graph-based tools Extensive knowledge of medical terminology, coding guidelines, and claims adjudication processes Strong analytical skills with a scientific approach to tasks Background in Special Investigations Unit (SIU) or Payment Integrity Independent, organized, and possessing excellent communication skills Virtual Vocations Inc
Vacancy posted 3 days ago
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