Fraud Detection & Claims Integrity Specialist

Verida, Inc.; Indianapolis (IN); On-site; USD 65,000 - 90,000; Full time

Job summary

Verida, Inc. is seeking a Program Integrity Specialist on a DC contract to audit claims, detect fraud, and ensure payment accuracy. The role focuses on root-cause analysis and process improvements across health plan operations.

You will work with internal teams to gather information, document findings, and prepare reports that support program integrity objectives. Strong analytical and communication skills are essential for success in a fast-paced environment.

Qualifications

• Bachelor's degree or two years investigative experience preferred.
• Proficient in Microsoft Office tools (Word, Excel, PowerPoint).
• Strong communication and organizational skills.

Responsibilities

• Audit a percentage of processed claims and document findings.
• Identify fraud, waste and abuse indicators across programs.
• Coordinate with internal departments and external sources to gather information.
• Create and analyze trend reports to identify improvement opportunities.
• Prepare internal reports and maintain case files in the tracking system.

Skills

Analytical skills

Problem solving

Communication

Interpersonal skills

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Verida, Inc. is seeking a Program Integrity Specialist on a DC contract to audit claims, detect fraud, and ensure payment accuracy. The role focuses on root-cause analysis and process improvements across health plan operations.

You will work with internal teams to gather information, document findings, and prepare reports that support program integrity objectives. Strong analytical and communication skills are essential for success in a fast-paced environment.