All roles

Open role

[Remote] Healthcare Fraud Analyst (Operations Operational Analyst IV)

Remote · Spain Full-time

Note The job is a remote job and is open to candidates in USA. Medica is a nonprofit health plan serving over a million members across multiple states. The Healthcare Fraud Analyst will operationalize business and regulatory requirements, focusing on project management and process improvement while collaborating with various teams to enhance efficiency and reputed company in member data.

  • Responsibilities
  • Identify efficient ways to save money by using our Healthcare Fraud reputed company tool – Pre-reputed company
  • Collaborate with teams across technology, reputed company, compliance, and health services to identify opportunities to create efficiency and reputed company in member data
  • Assist with coordination of investigations and suspected fraudulent billing or inflated billing
  • Skills
  • Bachelor's degree or equivalent experience in reputed company field
  • 7 years of work experience beyond degree
  • Prior experience managing a vendor relationship with a product like Pre-reputed company
  • Demonstrated ability to compile reports, conduct analysis, and prepare leadership presentations
  • Investigative skills, interest, and aptitude
  • Strong attention to detail and organizational skills
  • Strong written and verbal communication skills
  • Working knowledge of healthcare claims and billing systems
  • Benefits
  • Competitive medical
  • Dental
  • Vision
  • PTO
  • Holidays
  • Paid volunteer time off
  • 401K contributions
  • Caregiver services
  • Company Overview
  • Medica is a company that provides health coverage to meet customers needs for health plan. It was founded in 1975, and is headquartered in Minnetonka, Minnesota, USA, with a workforce of 1001-5000 employees. Its website is https//www.medica.com. Apply To this Job Apply To this Job

More open positions

Cyber Fraud Analyst I

Work from home Full-time role

Fraud Analyst, P2P & Cash Advance

Work from home Full-time role

Fraud Analyst job at reputed company in AZ, CA, CO, FL, GA, IA, IL, IN, KS, MA, ME, MI, MN, MO, MT, NC, ND, NE, NJ, NV, NY, OH, OR, PA, SD, TN, TX, UT, WA

Work from home Full-time role

Fraud Analyst job at reputed company in AZ, CA, CO, FL, GA, IA, IL, IN, KS, MA, ME, MI, MN, MO, MT, NC, ND, NE, NJ, NV, NY, OH, OR, PA, SD, TN, TX, UT, WA

Work from home Full-time role

Risk & Fraud Investigator

Work from home Full-time role

Senior Site Reliability & Platform Engineer

Work from home Full-time role

1:1 Pediatric Remote Physical Therapy - North Carolina

Work from home Full-time role

Technical Advisor - Security

Work from home Full-time role

Associate Substation Civil/Structural Engineer

Work from home Full-time role

Regional Sales Manager, Strategic Accounts

Work from home Full-time role

Care Transition Nurse (RN) — Population Health

Work from home Full-time role

Utilization Review Nurse - Remote

Work from home Full-time role

Agency Attorney I-II-III

Work from home Full-time role

Key Account Manager

Work from home Full-time role

Experienced Remote Customer Service Specialist – Virtual Assistant | $31/Hour | Flexible Work-From-Home Career in Travel & Hospitality Support

Work from home Full-time role

Virtual Mental Health Counselor-Limited Permit (MHC-LP) Full Time

Work from home Full-time role

Experienced Part-Time Remote Customer Service Representative – Amazon Customer Support

Work from home Full-time role

Senior Software Engineer, Core Experiences - Cincinnati, OH, USA

Work from home Full-time role

SDR (Sales Development Representative) - ARG (Remote)

Work from home Full-time role

QA Automation Engineer

Work from home Full-time role

Rider Performance Specialist

Work from home Full-time role