Prevention and Control Specialist

Job Summary

A company is looking for a Prevention & Control Specialist to monitor transportation benefit programs for fraud and compliance.

Key Responsibilities

• Conduct outreach to healthcare facilities to verify member rides and claims
• Investigate potential fraud by reviewing reports and documenting findings
• Utilize data management tools to track and analyze fraud investigation data

Required Qualifications

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