Financial Analyst - Fraud, Waste and Abuse (FWA)
Doctors Healthcare Plans • Coral Gables, FL10d • Onsite
Financial Analyst Jobs
5,640 jobs found — updated daily
Financial Analyst IV - Planning & Analysis
M&T Bank • Buffalo, NY10d • OnsiteIT Financial Analyst Internship
Builders FirstSource • Irving, TX10d • RemoteSenior Financial Analyst
Jabil • Tampa, FL10d • HybridFinancial Analyst III
Elbit America • Roanoke, VA10dPersonal Lines - Client Services Analyst
Cincinnati Financial • Fairfield, OH10d • $50,000 - $60,000Sr. Financial Analyst, Ambulatory
Adventist Health • Montebello, CA10d • OnsiteFinancial Analyst
Jordan Park Group • San Francisco, NY10d • HybridAssociate Financial Analyst
Molson Coors • Milwaukee, WI10d • $58,700 - $77,100 • HybridSr. Commercial Financial Analyst
Grecian Delights Kronos • Elk Grove Village, IL10d • OnsitePortfolio Analyst
Kestra Holdings • Dallas, TX10dSenior Financial Analyst
CVS Health • Woonsocket, RI10d • HybridSenior Financial Analyst
START EARLY • Chicago, IL10d • $69,000 - $82,000Financial Analyst I
Express • New York, NY10d • $70,200 - $99,700 • OnsiteFinancial Analyst
Penguin Random House US • New York, NY10d • HybridStrategic Financial Analyst, GTM
Benchling • San Francisco, CA10d • $119,000 - $150,000 • HybridSenior Financial Analyst Manager
Boeing • El Segundo, CA10d • $151,300 - $204,700 • OnsitePrincipal Financial Analyst
Capital One • McLean, VA10d • $109,900 - $137,900 • OnsiteCommercial Financial Analyst
BMO • Chicago, IL10d • $55,000 - $110,000 • OnsiteFinancial Analyst
Waters Corporation • , 10d • $54,000 - $90,000 • Onsite
Financial Analyst - Fraud, Waste and Abuse (FWA) (Onsite)
Doctors Healthcare Plans•Coral Gables, FL
•Onsite
About The Position
The Financial Analyst - Fraud, Waste and Abuse (FWA) is responsible for identifying, investigating and preventing fraudulent, wasteful and abusive activities related to healthcare claims, insurance, government programs, or organizational operations. This role uses data analysis, investigative techniques, and regulatory knowledge to detect suspicious patterns, minimize financial losses and ensure compliance with applicable laws and company policies.
Requirements
- Bachelor’s degree
- Three-year experience in healthcare and/or Medicare Advantage plans
- Experience with healthcare claims analysis, large data sets and claim analytics
- Ability to manage multiple investigations simultaneously
- Able to meet deadlines, multi-task and thrive in high-pressure environment
- Excellent oral and written communication
- Proficiency with MS office with advanced skills in Excel and SQL
- Experience with PowerBI and developing dashboards
- Ability to work independently and collaboratively in a team environment
Responsibilities
- Analyze medical, pharmacy, provider, and member-level claims data to identify potential FWA, overutilization, unusual billing patterns
- Perform data mining, auditing, trend analysis, outlier detection, and root-cause analysis across providers, members, CPT codes, diagnosis codes, DRG codes, and claim types.
- Generate and prioritize investigative leads
- Support pre-payment and post-payment review activities
- Recommend enhancements to claim edit rules and controls to prevent future improper payments
- Document models, provide investigative summaries and recommendations for review by FWA, Finance, Compliance, Medical Management, and other leadership.
- Produce FWA dashboard, and reports on savings and recoveries, trends and emerging risks, provider and member monitoring, etc.
- Support FWA program reporting, audit responses, policy/procedure development, and operational documentation
- Maintain confidentiality of sensitive information and investigative findings
- Meet performance goals as established for the position
- Perform additional duties and responsibilities as assigned by management
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Job Search Resources
Career Resources
Build a Resume for Financial Analyst
The resume builder that gets results.
- Get clear feedback so you look as qualified as you are
- Align your resume with the job to get further in the process, faster
- Take the guesswork out of resume writing
