Senior Fraud Analyst
virtual vocationsNew York, NY
Senior Fraud Analyst
virtual vocationsNew York, NYSenior L5
All Other Insurance Related ActivitiesInvestigation and Personal Background Check ServicesClaims Adjusting
APPLY NOWProactively identifying instances of fraud, waste, and abuse, the full-time Senior Fraud Analyst will analyze medical billing data and collaborate with engineering and data science teams to enhance anomaly detection algorithms in a remote work environment.
Key responsibilities:
Identify potential instances of fraud, waste, and abuse through data analysis
Support engineering and data science teams with audit and FWA concepts and data mapping
Validate and tune anomaly detection algorithms based on real-life experienceRequired qualificationsHands-on experience with medical billing errors and fraud analysis using analytic and SQL/graph-based tools
Extensive knowledge of medical terminology, coding guidelines, and claims adjudication processes
Strong analytical skills with a scientific approach to tasks
Background in Special Investigations Unit (SIU) or Payment Integrity
Independent, organized, and possessing excellent communication skills
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Level
Senior L5
Location
New York, NY
Occupation
Fraud Examiners, Investigators and Analysts
Industry
All Other Insurance Related Activities
Posted
yesterday