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
