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 tot his job
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Experienced Remote Chat Support Agent – Delivering Exceptional Customer Service and Building a Fulfilling Career with blithequark

Remote

Prior Authorization Manager

Remote

Creator Community Manager (TikTok Network)

Remote

Registered Nurse, Remote Patient Monitoring; RPM​/HYBRID

Remote

Human Resources (HR) Manager

Remote

Experienced Customer Service Live Chat Representative – Remote Work Opportunity with arenaflex for Dynamic and Tech-Savvy Individuals

Remote

Enterprise Account Executive

Remote

Beauty Sales - Beauty Rituals - The Shops at La Cantera

Remote

**Experienced Senior Examiner of Business Knowledge - blithequark Media Trade (CMX) - Remote, Part-Time Data Entry Position**

Remote

Finance Manager (Remote) - Forecasting, Budgeting & Analysis

Remote
← Back