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 Jobs

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

Remote Chat Support Agent – Part-Time – USA Remote Jobs

Remote Full-time

**Experienced Customer Support Consultant – Deliver Exceptional Service and Drive Business Growth at blithequark**

Remote Full-time

Staples Promotional Products: Special Order Account Representative

Remote Full-time

Web Design Tutor

Remote Full-time

**Experienced Customer Service Apprentice – Commercial & Institutional – Manage My Money Team at blithequark**

Remote Full-time

Freelance Product Tester - Up to $790/Week - High Earning Potential

Remote Full-time

**Experienced Full Stack Customer Support Representative – Disney Voyage Line Operations**

Remote Full-time

Netflix Remote Jobs Customer Service (Work At Home) - Apply Now

Remote Full-time

Experienced Call Center Agent and Customer Service Representative – Delivering Exceptional Client Experiences in a Dynamic and Supportive Environment at blithequark

Remote Full-time

**Experienced Remote Customer Service Representative – Delivering Exceptional Support Experiences at blithequark**

Remote Full-time
← Back to Home