Strategic Tax Analyst supporting tax planning for business groups. Facilitating complex tax analyses with a focus on fiscal efficiency and legal certainty.
About the role
- Revenue Cycle Advisor at HHAeXchange driving customer success and optimizing revenue cycle processes. Contributing to the growth and innovation of services in a fast-paced environment.
Responsibilities
- Analyze Medicaid claims, visit, and billing datasets using SQL and other analytical tools.
- Identify patterns and anomalies that may indicate fraud, waste, or abuse, including visit overlaps, inflated or duplicate billing, provider billing spikes, inconsistencies in electronic visit verification (EVV) data, unusual service combinations.
- Develop and refine detection queries and analytical logic that can be applied across datasets.
- Conduct proactive data analysis to identify emerging fraud patterns and potential program integrity risks.
- Translate analytical findings into clear requirements for product and engineering teams.
- Contribute to the design of fraud detection dashboards, alerting systems, and investigation workflows.
- Support the development of automated detection tools and AI-driven fraud identification capabilities.
- Test and validate fraud detection tools and analytics models as they are developed.
- Present analytical findings and insights to internal stakeholders and payer clients in a clear and actionable format.
- Support discussions with states and managed care organizations regarding fraud detection and program integrity.
- Document analytical methodologies and investigation approaches to support compliance and regulatory expectations.
Requirements
- 3–7 years of experience in healthcare analytics, payment integrity, fraud detection, program integrity, forensic data analysis, or a related field.
- Strong SQL proficiency, including the ability to independently query and analyze large datasets.
- Experience identifying patterns, anomalies, or outliers in large healthcare claims or billing datasets.
- Working knowledge of Medicaid or healthcare billing structures.
- Strong analytical and investigative problem-solving skills.
- Ability to communicate complex analytical findings to both technical and non-technical audiences.
- Comfort working in an evolving environment where new capabilities and processes are being developed.
- Experience using AI or machine learning tools for anomaly detection, fraud identification, or predictive analytics in healthcare claims data.
- Preferred: Experience with a payment integrity organization, healthcare analytics company, or managed care plan.
- Experience with Python, R, or advanced analytics tools.
- Experience with electronic visit verification (EVV) data.
- Professional certifications such as: Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), Certified in Healthcare Compliance (CHC).
- Experience with Medicaid home care, personal care services, or HCBS programs.
Benefits
- Competitive health plans
- Paid time-off
- Company paid holidays
- 401K retirement program with a Company elected match
- Other company sponsored programs
Job title
Job type
Experience level
Salary
Degree requirement
Tech skills
Location requirements
Analista de Processos Júnior focused on vigilância sanitária at SP Consult. Involves legalizing real estate and obtaining necessary sanitary licenses.
Senior Analyst driving digital transformation and adoption of IA in large companies with Microsoft Copilot. Leading initiatives on engaging and measuring value in strategies for technology.
Senior Analyst role focusing on implementing SAP HCM modules within a global HR IT team. Collaborating with stakeholders to enhance efficiency across various business units in Brazil.
Analista contábil responsável pelo cálculo de folha de pagamento e conciliação contábil para empresa de referência com 75 anos de mercado.
Senior Academic Analyst managing educational processes, student support, and event organization at YDUQS. Engaging with various stakeholders to ensure successful educational outcomes.
HR Analyst responsible for managing employee attendance and compliance with labor laws at GOL Linhas Aéreas. Ensuring accurate records and supporting various HR functions in a hybrid work environment.
Junior Accounting Analyst at Syhus, an accounting firm focused on technology companies. Responsibilities include tax closing, accessory obligations, and financial statement consolidation.
HR Analyst managing hiring processes for various employee types at Gol Airlines. Ensuring compliance with legal standards and internal policies in an inclusive work environment.
Designer developing visual concepts and layouts for institutional campaigns at a socio - environmental consultancy. Involves brand creation, graphic projects, and digital communication materials.