Fraud Prevention Specialist

Job Summary

Monitoring ride activity to identify potential fraud, the full-time Prevention and Control Specialist will analyze data, conduct outreach to healthcare facilities, and collaborate with internal teams to protect the integrity of the transportation benefit program while working remotely.

Key Responsibilities

• Conduct outreach to healthcare facilities to verify member rides and claims for accuracy
• Investigate potential fraud by assessing reports, performing detailed investigations, and documenting findings
• Utilize data management tools to track fraud investigations and generate reports for operational insights

Required Qualifications

• High school diploma or equivalent
• 1+ year of experience in customer service or healthcare operations
• Familiarity with Medicaid/Medicare or healthcare operations
• Comfortable using operational technical systems, including dashboards and spreadsheets
• Open to travel 10% of the time