Senior Healthcare Forensics Analyst

BDO; St. Louis (MO); On-site; USD 65,000 - 85,000; Full time

Job summary

BDO is seeking an Experienced Associate, Healthcare Forensics in the St. Louis area to identify and resolve payment inaccuracies across healthcare claims, supporting disputes, regulatory matters, and litigation.

You will analyze claims data, interpret payer policies, and develop remediation strategies while collaborating with cross-functional teams to ensure high-quality deliverables for clients.

Qualifications

• At least 3 years of healthcare consulting, revenue cycle, claims auditing, or payment integrity experience.
• Experience with Medicare, Medicaid, and Commercial reimbursement; familiarity with ICD-10, CPT, HCPCS coding.
• Active credential in CHC or a nationally recognized coding credential (e.g., CPC, CCS, RHIA).

Responsibilities

• Investigate and analyze to support clients, regulators, and litigation matters.
• Contribute to forensic engagements around medical coding, revenue cycle, and payment integrity.
• Analyze claims data to identify improper payments, errors, and potential fraud, waste, or abuse.
• Develop strategies to improve payment accuracy and mitigate overpayments.
• Collaborate with cross-functional teams to validate findings and advise corrective actions.
• Interpret payer policies and contracts to assess claim appropriateness.
• Prepare detailed reports and recommendations for clients and internal stakeholders.
• Support design and enhancement of payment integrity tools and audit methodologies.

Skills

Forensic Analytics

Compliance Analytics

Artificial Intelligence

Fraud Analytics

Education

High School Diploma

Bachelor’s degree in Healthcare Administration/Public Health/Business

Tools

Excel

SQL

SAS

Tableau

EPIC/Cerner/Athena

Job description

BDO is seeking an Experienced Associate, Healthcare Forensics in the St. Louis area to identify and resolve payment inaccuracies across healthcare claims, supporting disputes, regulatory matters, and litigation.

You will analyze claims data, interpret payer policies, and develop remediation strategies while collaborating with cross-functional teams to ensure high-quality deliverables for clients.