Remote Medicaid and Medicare Program Integrity Analyst II

Job ID: Available for Members

Location: Nationwide

Compensation: To Be Discussed

Staff Reviewed: Wed, Apr 01, 2020

Job Category: Healthcare, Information Technology, Insurance

Telecommute Level: Occasionally

Travel Requirements: Onsite Required, Some Travel

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Additional Information: Benefits Available

Job Summary

An insurance investigation company has an open position for a Remote Medicaid and Medicare Program Integrity Analyst II.

Core Responsibilities Include:

  • Performing evaluation and development of complaints to determine if referral as an investigation is warranted
  • Conducting independent reviews resulting from the discovery of situations that potentially involve fraud or abuse
  • Utilizing basic data analysis techniques to detect aberrancies in Medicare claims data

Qualifications for this position include:

  • Participate in onsite audits
  • At a minimum, a high school diploma
  • Preference will also be given to those individuals that have attained the Certified Fraud Examiners (CFE) designation
  • At least 1 year of experience in program integrity investigation/detection or a related field
  • Excellent oral, written and verbal skills
  • Ability to work independently with minimal supervision