CVS Health
10,000+ employees
Founded 1963
⚕️ Healthcare Insurance
🛒 Retail
🧘 Wellness
Healthcare Insurance • Retail • Wellness
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
Senior Analyst, Fraud Waste and Abuse
Job not on LinkedIn
🔥 0 minutes ago
📊 Check your resume score for this job
Improve your chances of getting an interview by checking your resume score before you apply.
CVS Health
10,000+ employees
Founded 1963
⚕️ Healthcare Insurance
🛒 Retail
🧘 Wellness
Healthcare Insurance • Retail • Wellness
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
📋 Description
• Leverage analytical skills to review claims data and identify patterns of suspected potential FWA. • At the direction of the Sr. Manager, assist in the triage, preliminary investigation of all internal and external FWA complaints • Refer all cases of suspected FWA to regulatory agencies within required timeframes • Assist in the monitoring of the FWA hotline and shared email box • Participate in prepayment review process including detailed review of medical records against claims data
🎯 Requirements
• 3-5 years’ work experience • CPC or equivalent coding certification • Working knowledge of standard industry coding guidelines such as CPT, HCPCs, ICD-10 • Experience reviewing medical records to ensure that documentation matches services billed • Experience reviewing detailed data to interpret claims data
🏖️ Benefits
• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs
Apply NowSimilar Jobs
🔥 2 minutes ago
Total Rewards Sr Analyst supporting design and administration of compensation programs at RTX. Collaborating with HR teams to enhance employee experience and coordinate Total Rewards projects.
🔥 2 minutes ago
Senior Analyst, Contracts overseeing a 5-year Army contract at RTX, the world's largest aerospace and defense company. Collaborating with multiple functions to manage contract compliance and address customer issues.
🔥 28 minutes ago
Board Certified Behavior Analyst providing behavior health services for children with autism and developmental disabilities. Conducting assessments, developing treatment plans, and collaborating with support teams.
🔥 29 minutes ago
Analyst supporting IT Asset Management program for federal clients, coordinating strategic planning and governance documents. Managing stakeholder engagement and executing program objectives.
🔥 30 minutes ago
Insider Threat Analyst safeguarding billions in digital assets for Coinbase. Detecting, investigating, and mitigating threats as part of the Insider Threat team.
🇺🇸 United States – Remote
💵 $135.3k - $159.2k / year
💰 $21.4M Post-IPO Equity on 2022-11
⏰ Full Time
🟡 Mid-level
🟠 Senior
🧐 Analyst
🦅 H1B Visa Sponsor
