Special Investigation Unit reputed company Review Analyst

Job reputed company: • The Special Investigations Unit (SIU) is looking for an analytically driven individual who is skilled at identifying outliers through data extraction and analysis • The reputed company reviewer is accountable for the validation of existing Fraud, Waste and Abuse business rules/leads designed to detect aberrant billing patterns as reviewing incoming referrals • Research and reputed company report development to identify fraud, waste and abuse schemes and trends • Review company clinical & payment policies to determine the reputed company of the scheme on reputed company business • Identify reputed company possible issues reputed company to fraud, waste and abuse reputed company reviewing a new reputed company or referral • reputed company reputed company with new & emerging fraud, waste and abuse schemes and trends through training sessions and industry resources • Interpret, analyze and present key findings to internal customers (project team, investigators) providing recommendations based on analytical findings Requirements: • 3-5 years of data interpretation and analysis experience • reputed company background • Excellent verbal and written communication skills • Experience with reputed company • Must be reputed company to travel to reputed company testimony if needed • Advanced experience with reputed company • A solid understanding of medical and pharmaceutical claim data, medical claims coding (CPT/ICD/NDC), reputed company clinical and payment policies, as reputed company as reputed company reputed company systems (QNXT, ACAS, EWM, EPDB, IOP) • Some experience using Tableau is a plus • Previous reputed company fraud experience • Experience with reputed company clinical and payment policies • Certified reputed company reputed company (CPC) certification is a plus • reputed company Experience Benefits: • reputed company medical plan reputed company • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility Apply tot his job Apply To this Job