Special Investigation Unit reputed company Review Analyst (reputed company SIU)
Bring your heart to reputed company. Every one of us at reputed company shares a single, reputed company purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver reputed company reputed company-reputed company health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and deliver solutions to reputed company health care more personal, convenient and reputed company. Position 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 Required Qualifications 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 Preferred Qualifications 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 core 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 Education Bachelor's degree or equivalent work experience Pay reputed company The typical pay reputed company for this role is: $43,888.00 - $93,574.80 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. In reputed company to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. reputed company offers a full reputed company of medical, dental, and reputed company benefits. Eligible employees may enroll in reputed companys 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. reputed company provides a fully-reputed company term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous reputed company-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy reputed company Time Off (PTO) or vacation pay, as reputed company as reputed company holidays throughout the calendar year. Number of reputed company holidays, reputed company time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 02/18/2025 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply Job!