What are the responsibilities and job description for the 155300 Data Analyst Fraud Waste & Abuse position at JSM Consulting Inc.?
Job Description
Description -
The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You will be working with a State Government Product and Data Mining team. Your primary responsibility will be to assist in the development and deployment of algorithms designed to support program integrity across various platforms and states plus support our fraud and abuse detection product and services.
Qualifications
Required Qualifications:
5 years of experience writing advanced SQL queries
5 years of fraud, waste and abuse data mining experience
4 years of data analysis experience working with database structures
4 years of healthcare claims experience
Preferred Qualifications
Description -
The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You will be working with a State Government Product and Data Mining team. Your primary responsibility will be to assist in the development and deployment of algorithms designed to support program integrity across various platforms and states plus support our fraud and abuse detection product and services.
Qualifications
Required Qualifications:
5 years of experience writing advanced SQL queries
5 years of fraud, waste and abuse data mining experience
4 years of data analysis experience working with database structures
4 years of healthcare claims experience
Preferred Qualifications
- Industry certifications: Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE)
- Experience with statistical analysis of data
- Knowledge of Medicaid policy and real-life fraud, waste, abuse schemes
- Knowledge of healthcare claim adjudication systems
- Experience with Rally