- US Bank (Cincinnati, OH)
- …from Day One. **Job Description** We are hiring for an exciting opportunity as a Fraud Risk Analyst within US Bancorp's Quantitative Fraud Strategy team. In ... Success in this position requires a deep understanding of fraud risk and advanced analytical skills using tools such...may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional… more
- Molina Healthcare (Columbus, OH)
- …emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst , Data is responsible for data compilation, data management, data ... coordinating data extractions, gathering requirements, supporting payment integrity teams, primarily fraud , waste and abuse. + Experience working on SQL, PowerBI,… more
- CVS Health (Columbus, OH)
- …3-5 years. + Strong analytical and investigative skills, with experience in healthcare fraud detection. + Proficiency in interpreting claims data, medical ... it all with heart, each and every day. **Position Summary** The Senior Analyst , Investigations at Aetna International plays a pivotal role in safeguarding the… more
- Elara Caring (Toledo, OH)
- …to effectively collaborate with cross-functional teams. + Understanding of Federal and State healthcare laws and regulations pertaining to fraud , waste and abuse ... our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right...to make a difference as PCS Quality and Compliance Analyst **.** Being a part of something this great… more
- Carrington (Columbus, OH)
- …our amazing team and work remote from home!** The Quality Control Servicing Analyst will be responsible for independently conducting audits of the servicing business ... regulatory requirements, and investor/agency/product specific guidelines. Also, ensure that all fraud red flags are identified and fully investigated, and findings… more
- CVS Health (Columbus, OH)
- …plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing ... Aetna business. + Keep current with new and emerging fraud , waste, and abuse schemes and trends through training...3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and… more
- CVS Health (Columbus, OH)
- …actuarial analysis to assess the financial risks and implications of healthcare programs, insurance products, and benefit plan designs. + Completes financial ... forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost… more
- CVS Health (Columbus, OH)
- …communication skills + Advanced experience in Excel **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Knowledge of Medicaid ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud… more
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