Healthcare Financial Consultant
2 weeks ago
A prominent Federal Agency is in search of a dedicated Healthcare Financial Consultant to join their team.
Key Responsibilities:
1. Conduct comprehensive data analysis to uncover instances of fraud, waste, or abuse within claims data.
2. Evaluate and scrutinize the financial and operational activities of diverse entities, including businesses, partnerships, and financial institutions.
3. When applicable, review relevant financial documents, accounting records, operational reports, and other materials related to the investigations.
4. Utilize financial reports and automated systems to analyze intricate data and transactions.
5. Collect and assess a broad range of financial documents from various sources; conduct interviews with witnesses and involved parties; and present findings to relevant stakeholders.
6. Leverage knowledge of healthcare coding standards, fraud detection methodologies, and applicable laws to identify suspicious trends in claims data.
7. Maintain a thorough understanding of healthcare reimbursement policies and regulations concerning fraud and abuse at both state and federal levels.
8. Collaborate with legal and support teams to compile evidence, create visual aids, and prepare materials for legal proceedings.
9. Draft clear interim and final reports detailing investigation progress, significant findings, and recommendations for further actions.
10. Ensure the confidentiality and security of all sensitive materials encountered during the course of duties.
Qualifications:
- Bachelor’s degree in accounting, finance, economics, or a related field.
- Preferred certifications include Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE).
Experience:
- Minimum of 3 years in Healthcare Fraud Analysis is preferred.
Required Skills:
- Proficient in assessing compliance with governmental standards and accounting principles.
- Strong understanding of financial analysis for healthcare entities, including the review of financial statements.
- Familiarity with budget management and execution processes.
- Knowledge of debt collection practices and fiscal management.
- Ability to monitor financial obligations and provide insightful reporting.
- Competence in activity-based costing and business case analysis.
- Proficient in using computer systems, including EXCEL and ACCESS, for data management.
The Midtown Group is an Equal Opportunity Employer, committed to diversity and inclusion in the workplace.
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