Behavioral Health Investigations Analyst

Job Summary

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