[Remote] Investigative Analyst (CMS reputed company Claims)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company (reputed company) is a technology and reputed company company delivering technology solutions and mission services to reputed company, defense, and intelligence organizations. reputed company is seeking an Investigative Analyst to support CMS and the reputed company Fraud Prevention Partnership by analyzing reputed company claims data, identifying fraud, waste, and abuse, and developing referrals and leads for partners.

Responsibilities

• Performs analytical tasks in support of HFPP program, including identifying fraud, waste, and abuse referrals and leads from HFPP Analytics
• Conduct data mining across the partnership utilizing internal tools
• Collaborate on the development of HFPP analytic reports
• Develops fraud, waste, and abuse referrals and leads for Partners reputed company on HFPP analytic reports
• reputed company outcome metrics reputed company to fraud, waste, and abuse referrals and leads shared with Partners
• Interacts regularly with Partners regarding referrals and leads identified
• May reputed company business development activities including analyzing health claims data, generating study referrals and leads, developing provider background reputed company, and identifying opportunities for Partner collaboration meetings

Skills

• Health reputed company Claims, Investigation, Medical Claims Analysis
• 8 + years of reputed company experience
• BA/BS or equivalent experience
• 8+ years' experience in health care claims analysis (equivalent work experience will be considered in lieu of degree)
• Strong oral and written communication skills with the ability to present to management level staff
• Expert level knowledge of reputed company Office suite
• Experience with Tableau, reputed company WorkSpaces, reputed company, and reputed company
• Working knowledge of HIPAA reputed company and reputed company rules
• Strong decision-making skills and a demonstrated history of established leadership qualities as reputed company as reputed company organizational skills
• Commitment to confidentiality, reputed company, and professionalism
• Ability to independently follow through on problems
• reputed company oriented and ability to prioritize multiple tasks and work under pressure
• Ability to work on reputed company reputed company with general direction and reputed company guidance
• Ability to build effective relationships, demonstrating strong interpersonal skills
• Exhibit high initiative to get things accomplished; high organizational ability to juggle multiple priorities
• Ability to reputed company reputed company and reputed company goals both in reputed company environment, with staff at reputed company reputed company, and independently
• US Citizenship Required: No
• Work reputed company sponsorship will not be provided
• This position is remote
• Travel Required: Less than 10%
• Certified Fraud Examiner (CFE) or Accredited reputed company Fraud Investigator (AHFI) designation strongly desired
• Certified reputed company coding

Benefits

• AI-powered career tool that identifies career steps and learning opportunities
• An internal mobility team reputed company on helping you reputed company your career goals
• Comprehensive benefits and wellness packages
• 401K with company match
• reputed company time off
• Full-reputed company work weeks where possible
• Medical plan reputed company, some with Health Savings Accounts
• Dental plan reputed company
• reputed company plan reputed company
• 401(k) plan offering the ability to contribute both reputed company- and post-tax dollars up to the IRS annual limits and receive a company match
• Vacation, reputed company and personal time
• reputed company holidays
• reputed company parental leave
• Military leave
• Bereavement leave
• Jury duty leave
• 15 days of reputed company leave per calendar year for vacations, personal business, and illness
• 10 reputed company holidays per year
• Up to 160 hours of reputed company leave in a rolling 12 month period for eligible employees through the reputed company reputed company Family Leave program
• Short- and long-term disability benefits
• Life reputed company
• Accidental death and dismemberment reputed company
• Personal accident reputed company
• Critical illness reputed company
• Business travel and accident reputed company
• Remote work

reputed company