Mass General Brigham Health Plan is seeking a Fraud Analyst to support the Special Investigations Unit by building data analytics to identify fraud leads. This role uses SQL and claims data to develop analytic reports, investigate suspicious billing patterns, and support Fraud Investigators.
The position also includes preliminary research on providers or members using public records, contracts, and social media, along with documentation of investigative findings in clear reports or memoranda. The role is hybrid, with at least one onsite team meeting per month in Somerville, MA.
- Bachelor's degree
- 2-3 years of experience investigating claims or compliance
- 2-3 years of experience as an analyst in healthcare, data reporting, or data analysis
- Healthcare fraud experience highly preferred
- Proficiency with SQL strongly preferred
- Strong knowledge of CPT, HCPCS, ICD-10-CM diagnosis, and procedure codes
- Strong verbal and written communication skills
- Excellent analytical, critical thinking, and organizational skills
- Ability to work with technology-based solutions and present findings clearly
- Competitive salary
- Comprehensive benefits package
- Flexible work options
- Career growth opportunities
- Recognition programs
- Hybrid work arrangement
Location
Massachusetts, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$63,648 - $92,570
Remote work allowed
Yes
Posted
1 month ago