- Prime Therapeutics (Madison, WI)
- …and drives every decision we make. **Job Posting Title** Recovery & Resolution Analyst **Job Description** The Recovery & Resolution Analyst is responsible for ... are accurately processed in Prime's systems for recoupment of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations … more
- Molina Healthcare (Kenosha, WI)
- **Job Description** **Job Summary** Under direct supervision of the Manager, the Reporting Analyst , SIU supports a team in the Special Investigation Unit (SIU). The ... Reporting Analyst , SIU will ensures FWA referrals are logged, documented,...and internal policies and procedures + Supports the Special Investigations Unit (SIU) Manager, Director, and team in the… more
- Highmark Health (Madison, WI)
- …decision support and reporting tools. Recommends innovative approaches to analytical investigations . Performs modeling of data sources and flows, works with data ... **Required** + 5 years of relevant, progressive experience as a Decision Support Analyst or equivalent training and experience in a business or clinical environment… more
- Intermountain Health (Madison, WI)
- …system design procedures, test procedures and quality standards. + Investigations changes in reimbursement and communicates potential impacts to reimbursement. ... Communicates effectively with site and system financial leadership to establish key financial variables requiring special analysis. **Skills** + Reconciliation + Accounting + Accounts Payable/Receivable Process + Medicare + Medicaid + General Ledger +… more
- Lumen (Madison, WI)
- …by internal and external partners. + Conduct network analysis, forensic investigations and malware analysis to identify malicious activity and derive Indicators ... of Compromise (IOCs) and associated detection rules. + Work with team to scale analysis of evolving threats and tracking threat actors leveraging support from data science tools sets developed by data scientists at the Lab such as machine learning and graph… more
- Sedgwick (Madison, WI)
- …Claims **PRIMARY PURPOSE** **:** To be responsible for managing SIU investigations of complex fraud schemes involving providers, vendors, attorneys and others; ... matters. + Mentors and provides guidance to the SIU complex fraud team, analyst and compliance teams. + Initiates and directs SIU compliance activities including… more
- Lincoln Financial (Madison, WI)
- …data and context necessary to initiate IR response. In addition, the analyst will be responsible for maintaining multiple security technologies for detecting and ... expertise in Operating Systems (Windows/Linux) operations and artifacts to assist in investigations . + Ability to analyze different data types from various sources… more