Healthcare Forensics Analyst: Payment Integrity

BDO; Nashville (TN); On-site; USD 65,000 - 85,000; Full time

Job summary

BDO in Nashville seeks an Experienced Associate, Healthcare Forensics to identify and resolve payment inaccuracies across healthcare claims, supporting disputes, investigations, and regulatory compliance. You will work on fraud, waste, and abuse, applying data analytics to improve payment integrity and client outcomes.

The role requires strong knowledge of payer policies, coding (ICD-10, CPT, HCPCS), and tools like Excel, SQL, SAS, and Tableau, with collaboration across teams to deliver

Qualifications

• Three years of healthcare consulting or revenue cycle experience.
• Experience with Medicare, Medicaid, and commercial reimbursement.
• Knowledge of ICD-10, CPT, HCPCS coding.
• Ability to analyze claims data and identify improper payments.
• Active credential in coding or healthcare compliance.

Responsibilities

• Provide investigation and analysis to clients, regulators, and counsel.
• Contribute to forensic engagements in medical coding and billing.
• Analyze healthcare claims data to identify improper payments or fraud.
• Develop strategies to improve payment accuracy and reduce overpayments.
• Collaborate with cross-functional teams to validate findings and actions.
• Prepare detailed reports and present recommendations to stakeholders.

Skills

Excel

SQL

SAS

Tableau

Regulatory knowledge

Education

High School Diploma

Bachelor’s in Healthcare Admin

Tools

EPIC

Cerner

Athena

Coding/DRG software

Job description

BDO in Nashville seeks an Experienced Associate, Healthcare Forensics to identify and resolve payment inaccuracies across healthcare claims, supporting disputes, investigations, and regulatory compliance. You will work on fraud, waste, and abuse, applying data analytics to improve payment integrity and client outcomes.

The role requires strong knowledge of payer policies, coding (ICD-10, CPT, HCPCS), and tools like Excel, SQL, SAS, and Tableau, with collaboration across teams to deliver