Senior Fraud, Waste and Abuse Specialist

This is a fully remote position, open to applicants in Florida.

📋 Description

• Assist in the development and upkeep of the Payment Integrity and Fraud, Waste, and Abuse (FWA) program framework.

• Create, execute, and sustain program policies, workflows, procedures, and controls.

• Oversee centralized systems for tracking and reporting investigations, recoveries, referrals, and regulatory activities.

• Act as the main point of contact with CMS, MEDIC, OHA, Medicaid Fraud Units, and various oversight agencies.

⛳️ Requirements

• At least 5 years of experience in fraud, waste, and abuse (FWA).

• Proven experience in analyzing healthcare claims data.

• Familiarity with payment integrity practices.

• A bachelor's degree in business or a related field is mandatory.

🏝️ Benefits

• Health insurance.

• Flexible work arrangements.