Behavioral Health Investigations Analyst

A company is looking for a Behavioral Health FWAE Investigations Analyst - Remote.

Key Responsibilities

Investigate and review claims for trends related to Fraud, Waste, Abuse, and Errors

Interpret state and federal mandates, billing practices, and medical policies to make recommendations

Collaborate with business partners to resolve complex claims issues and participate in client meetings

Required Qualifications

2+ years of investigative experience

1+ years of experience working with healthcare claims data

Demonstrated advanced proficiency with MS Excel, including v-lookups and pivot tables