Healthcare Fraud Analyst

Job Summary

A company is looking for a Healthcare Fraud Analyst (Operations Operational Analyst IV).

Key Responsibilities

• Identify efficient ways to save money using the Healthcare Fraud Shield tool - Pre-Shield
• Collaborate with teams across technology, security, compliance, and health services to enhance efficiency and security in member data
• Assist with the coordination of investigations related to suspected fraudulent or inflated billing

Required Qualifications

• Bachelor's degree or equivalent experience in a related field
• 7 years of work experience beyond the degree
• Prior experience managing a vendor relationship with a product like Pre-shield
• Demonstrated ability to compile reports, conduct analysis, and prepare leadership presentations