Job Details

A company is looking for an FWA Investigative Analyst-Pharmacy.Key ResponsibilitiesInvestigate potential pharmacy fraud, waste, or abuse using analytical tools and external referralsAnalyze claims data for suspicious patterns and develop effective investigative strategiesDocument investigative activities and maintain communication with clients regarding case progressRequired Qualifications and Education2-5 years of experience in pharmacy/healthcare investigations related to fraud, waste, and abuseBachelor's degree from a 4-year college or university or equivalent training and experienceStrong analytical reasoning skills and knowledge of the pharmaceutical industry and claims processingExperience with medical and pharmacy claim processing; claim billing experience is a plusProficiency in MS Excel and Word; willingness to learn proprietary software and systems