Pharmacy Fraud Investigative Analyst

Job Summary

A company is looking for an FWA Investigative Analyst-Pharmacy.

Key Responsibilities

• Investigate potential pharmacy fraud, waste, or abuse using analytical tools and external referrals
• Analyze claims data for suspicious patterns and develop effective investigative strategies
• Document investigative activities and maintain communication with clients regarding case progress

Required Qualifications and Education

• 2-5 years of experience in pharmacy/healthcare investigations related to fraud, waste, and abuse
• Bachelor's degree from a 4-year college or university or equivalent training and experience
• Strong analytical reasoning skills and knowledge of the pharmaceutical industry and claims processing
• Experience with medical and pharmacy claim processing; claim billing experience is a plus
• Proficiency in MS Excel and Word; willingness to learn proprietary software and systems