Pharmacy Fraud Investigator-Remote

Remote Full-time
About the position Responsibilities • Directly interact with multiple levels within partner organizations to coordinate Fraud Waste and Abuse activities. • Coordinate multiple investigations to manage investigative outreach and communicate case details between external and internal investigators. • Facilitate triage and coordination of partner fraud tips and communicate the outcomes in an intelligent, professional, and informed manner. • Work with partner and SIU management to proactively seek out process improvement as the relationship matures and areas of opportunities are identified. • Understand back-end systems and reporting processes to troubleshoot gaps or issues. Requirements • College degree in related field preferred or 3+ years of equivalent work experience. • Relevant experience as a Fraud Investigator in healthcare. • Certified Pharmacy Technician, Certified Fraud Examiner, or similar certification strongly desired. • Highly proficient in Microsoft Access & Excel, and data warehousing applications. • Excellent organizational and interpersonal skills, critical thinking and planning skills, verbal and written communication skills. • Ability to present to clients and internal stakeholders. • Ability to work well with senior management and high level external contacts, handle sensitive or confidential information is critical, work with minimum management oversight on multiple projects with competing priorities. • Ability to work a flexible schedule to accommodate project deadlines. Benefits • Comprehensive health-related benefits including medical, vision, and dental coverage. • Well-being and behavioral health programs. • 401(k) with company match. • Company paid life insurance. • Tuition reimbursement. • A minimum of 18 days of paid time off per year and paid holidays.
Apply Now

Similar Opportunities

Online Video Game QA Tester Jobs – Remote Role

Remote Full-time

American Airlines Job Submissions $25/Hour

Remote Full-time

Google – UX Design Manager, Augmented Reality and Virtual Reality – San Francisco, CA

Remote Full-time

Remote Prior- Authorization Pharmacist - PBM

Remote Full-time

Work from Home Prior Authorization Pharmacist- Must reside in California

Remote Full-time

Work from Home Clinical Pharmacist- reside in Texas

Remote Full-time

Endeavor Health is hiring: Dental Billing Representative - Remote in Northbrook

Remote Full-time

VIP Guest Services Manager, Disney Cruise Line

Remote Full-time

Contract Coordinator

Remote Full-time

Sr Salesforce Developer

Remote Full-time

Qualitative Product Researcher II, Merchants

Remote Full-time

Nurse Navigator - Oncology Lung

Remote Full-time

Experienced Customer Service Partner – Order Fulfillment, Sales Expansion, and Customer Relationship Management at blithequark

Remote Full-time

**Evening Specimen Processor - Data Entry - Part-Time | West Houston, TX**

Remote Full-time

Experienced Customer Care Specialist – Delivering Exceptional Support and Driving Business Growth through Innovative Food Ordering Solutions at blithequark

Remote Full-time

**Experienced Full Stack Customer Success Manager – High-Touch Commercial Customer Success Program**

Remote Full-time

Staff Data Analyst, Credit Analytics job at Upstart in US National

Remote Full-time

RN PRN-Remote Patient Monitoring

Remote Full-time

**Experienced Healthcare Customer Service Representative - Remote Opportunity with Flexible Scheduling**

Remote Full-time

Experienced Part-Time Remote Customer Service Representative – Delivering Exceptional Support Experience for blithequark

Remote Full-time
← Back to Home