Senior Analyst, Fraud Investigation

A company is looking for a Senior Analyst in the Special Investigations Unit. Key Responsibilities Analyze large datasets to identify patterns and trends indicative of fraudulent activity Collaborate with auditors and investigators to prepare reports and manage fraud-related referrals Develop comprehensive reports summarizing analyses and coordinate with internal departments on fraud targeting criteria Required Qualifications Bachelor's degree in business, healthcare administration, criminal justice, or a related field Minimum of 3 years of experience in healthcare fraud investigation or medical claims analysis Proficiency in data analysis tools and knowledge of statistical analysis techniques Experience in analyzing healthcare claims data and familiarity with Medicare and Medicaid regulations Experience in a health plan SIU is highly desirable

Apr 22, 2025 - 19:41

A company is looking for a Senior Analyst in the Special Investigations Unit. Key Responsibilities Analyze large datasets to identify patterns and trends indicative of fraudulent activity Collaborate with auditors and investigators to prepare reports and manage fraud-related referrals Develop comprehensive reports summarizing analyses and coordinate with internal departments on fraud targeting criteria Required Qualifications Bachelor's degree in business, healthcare administration, criminal justice, or a related field Minimum of 3 years of experience in healthcare fraud investigation or medical claims analysis Proficiency in data analysis tools and knowledge of statistical analysis techniques Experience in analyzing healthcare claims data and familiarity with Medicare and Medicaid regulations Experience in a health plan SIU is highly desirable