Pharmacy Fraud Investigative Analyst

Job Summary

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

Key Responsibilities

• Investigate cases of potential pharmacy fraud, waste, or abuse using analytical tools and external referrals
• Analyze claims data to identify suspicious patterns and develop efficient investigative strategies
• Document investigative activities and maintain case files while ensuring compliance with internal procedures

Required Qualifications

• 2-5 years of experience in pharmacy/healthcare fraud, waste, and abuse investigations
• Bachelor's degree 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 and workflow
• Familiarity with MS Excel and Word; willingness to learn proprietary software