Fraud Investigator-Kansas City, MO area

Tasks

• Conduct fraud waste and abuse investigations
• Coordinate claim overpayment recovery activities
• Coordinate subpoena responses
• Maintain case files and document outcomes
• Monitor fraud hotlines and external fraud alerts
• Perform FWA risk assessments using data analytics
• Prepare case reports and recommendations
• Prepare executive and audit committee reports
• Support FWA training program

Perks/Benefits

• 401k
• Adoption financial assistance
• Adoption leave
• Dental benefits
• Employee discounts
• Health benefits
• Mentorship
• Paid Holidays
• Paid parental leave
• Paid time off
• Professional development courses
• Tuition reimbursement
• Vision benefits
• Volunteer time off

Skills/Tech-stack

Business Intelligence | CPT | Case management | Claims Processing | Claims data | Claims data analysis | Data Analysis | Data analytics | Excel | Fraud Investigations | Fraud Risk Assessment | Fraud risk | Healthcare Claims | Healthcare Fraud | Healthcare Fraud Investigations | ICD10 | Medical terminology | Pharmacy | Power BI | Report Writing | Risk Assessment | Subpoena Response