Remote Medicaid/Medicare Program Integrity Analyst II

Coventbridge Integrity Systems; Grove City (OH); Hybrid; USD 70,000 - 77,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Life, LTD and STD paid by the employer

401(k) with company match

Paid Time Off and holidays

Tuition assistance after 1 year

Job summary

CoventBridge Integrity Systems seeks a Medicaid/Medicare Program Integrity Analyst II for remote work, based in Grove City, OH or a home office. You will evaluate leads, conduct reviews of potential fraud, and utilize data analysis to identify aberrancies in claims data.

You will prepare fraud alerts, reports, and correspondence, mentor staff, and contribute to protecting healthcare programs from fraud, waste, and abuse. Salary ranges and benefits are provided by the company.

Qualifications

• High School diploma or GED; college/technical degree preferred.
• CFE certification preferred.
• At least 1 year in program integrity investigation or related field.
• Strong research and organizational skills.
• Ability to work independently in a fast-paced environment.

Responsibilities

• Evaluate leads, complaints, and investigations to determine next steps.
• Conduct independent reviews of potential fraud or abuse.
• Analyze Medicare/Medicaid claims data to detect variances.
• Prepare reports, fraud alerts, and external correspondence.
• Mentor/train new PI staff.

Skills

Research skills

Communication skills

Independent worker

Multitasking

Statistical knowledge

Education

High School Diploma or GED

CFE certification

Tools

Data analysis tools

Statistics software

Job description

CoventBridge Integrity Systems seeks a Medicaid/Medicare Program Integrity Analyst II for remote work, based in Grove City, OH or a home office. You will evaluate leads, conduct reviews of potential fraud, and utilize data analysis to identify aberrancies in claims data.

You will prepare fraud alerts, reports, and correspondence, mentor staff, and contribute to protecting healthcare programs from fraud, waste, and abuse. Salary ranges and benefits are provided by the company.