SIU Analyst

2 days ago

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+

Description

• Position in the Special Investigations Unit for data analysis and fraud detection. • Validate existing fraud detection business rules and review incoming referrals. • Research and develop reports to identify fraud trends. • Keep updated with new fraud schemes through training.

Requirements

• 3-5 years of data interpretation and analysis experience. • Healthcare background. • Excellent verbal and written communication skills. • Experience with healthcare coding. • Must be able to travel to provide testimony if needed. • Advanced experience with Excel. • A solid understanding of medical and pharmaceutical claim data and coding is preferred. • Some experience using Tableau is a plus. • Previous healthcare fraud experience is preferred. • Certified Professional Coder (CPC) certification is a plus.

Benefits

• Full range of medical, dental, and vision benefits. • Eligible employees may enroll in the 401(k) retirement plan. • Employee Stock Purchase Plan available for eligible employees. • Fully-paid term life insurance plan for eligible employees. • Short-term and long-term disability benefits. • Well-being programs and education assistance. • Free development courses and discounts at CVS stores and with partners. • Paid Time Off (PTO) and paid holidays throughout the year.