Senior Healthcare Forensics Associate: Payment Integrity

DaMar Staffing; Seattle (WA); On-site; USD 65,000 - 85,000; Full time

Job summary

DaMar Staffing is seeking an Experienced Associate in Healthcare Forensics to identify, analyze, and resolve payment inaccuracies across healthcare claims. You will work on reimbursement disputes, fraud, waste, and abuse investigations, interpreting payer policies and regulatory guidelines to assess claim appropriateness.

The role requires strong data analytics, knowledge of healthcare reimbursement methodologies, and the ability to present findings to clients and stakeholders.

Qualifications

• Bachelor’s degree in healthcare-related field required.
• Three years of healthcare consulting or revenue cycle experience required.
• Experience with Medicare/Medicaid, coding, and payer policies preferred.

Responsibilities

• Provides investigation and analysis for litigation and regulatory matters.
• Analyzes claims data to identify improper payments and potential fraud.
• Develops strategies to improve payment accuracy and mitigate overpayments.
• Prepares detailed reports and recommendations for clients and internal stakeholders.
• Stays current on CMS regulations and payment models.
• Collaborates with cross-functional teams to validate findings.

Skills

Healthcare reimbursement

Data analysis

Regulatory compliance

CMS regulations

Fraud analytics

Project management

Education

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

Tools

SQL

Excel

Tableau

SAS

Job description

DaMar Staffing is seeking an Experienced Associate in Healthcare Forensics to identify, analyze, and resolve payment inaccuracies across healthcare claims. You will work on reimbursement disputes, fraud, waste, and abuse investigations, interpreting payer policies and regulatory guidelines to assess claim appropriateness.

The role requires strong data analytics, knowledge of healthcare reimbursement methodologies, and the ability to present findings to clients and stakeholders.