Healthcare Forensics Associate - Payment Integrity & Compliance

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

Job summary

DaMar Staffing seeks an Experienced Associate in Healthcare Forensics to identify and resolve payment inaccuracies across healthcare claims, supporting disputes, regulatory matters, and litigation. The role requires strong data analysis, understanding of reimbursement methodologies, and independent work within client engagements.

The candidate should have 3+ years in healthcare consulting or revenue cycle, with credentials in coding or compliance.

Qualifications

• Requires High School Diploma or equivalent.
• Bachelor's degree in Healthcare Administration, Public Health, or Business preferred.
• 3 years of healthcare consulting, revenue cycle, claims auditing, or payment integrity experience required.
• Experience with Medicare, Medicaid, Commercial reimbursement, coding (ICD-10, CPT, HCPCS) and claims processing preferred.
• Active credential in coding (e.g., CPC, CCS, RHIA) and/or CHC is required.

Responsibilities

• Provides investigation and analysis to clients, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters.
• Analyzes healthcare claims data to identify improper payments, billing errors, and potential fraud, waste, or abuse.
• Develops and implements strategies to improve payment accuracy and mitigate overpayments.
• Collaborates with cross-functional teams to validate findings and recommend corrective actions.
• Prepares and presents detailed reports and recommendations to clients and internal stakeholders.

Skills

Analytical thinking

Communication

Project management

Forensic Analytics

Fraud Analytics

Education

High School Diploma

Bachelor's degree in Healthcare Administration, Public Health, or Business

Tools

Excel

SQL

SAS

Tableau

Job description

DaMar Staffing seeks an Experienced Associate in Healthcare Forensics to identify and resolve payment inaccuracies across healthcare claims, supporting disputes, regulatory matters, and litigation. The role requires strong data analysis, understanding of reimbursement methodologies, and independent work within client engagements.

The candidate should have 3+ years in healthcare consulting or revenue cycle, with credentials in coding or compliance.