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Fraud Monitoring & Compliance Investigations Specialist

Company: Institute for Credentialing Excellence
Location: Alpharetta
Posted on: April 5, 2021

Job Description:

Institute for Credentialing Excellence (ICE)

  • Fraud Monitoring & Compliance Investigations Specialist CH Fraud Monitoring & Compliance Investigations Specialist --The Legal & Compliance Organization is recruiting for a Fraud Monitoring and Compliance Investigations Specialist that will support the Enterprise Investigations program. --The successful candidate will be a multi-faceted compliance and ethics professional with a background in fraud detection and prevention. The individual will support the Investigations program activities related to identifying and analyzing data. Ideal candidate will also have experience in several core compliance areas and managing an enterprise EthicsLine. This position is heavily data analysis driven; therefore, it requires keen data analysis and visualization skills and must have the ability to distill large amounts of data into meaningful, concise and visually appealing metrics and measurements to report to management. --Specific Duties Will Include: --1) analyze compliance and incident data, identify trends and draft quarterly presentations 2) responsible for triaging cases that come through the company's EthicsLine and ensure proper case documentation and closure of each investigation to prepare analysis of investigative data for trending and reporting 3) to manage the annual reporting requirements for the Physician Payment Sunshine Act and applicable State reporting requirements. --The candidate will work collaboratively with members of the Legal and Compliance Organization and will successfully build, maintain, and strategically influence relationships across all areas of the company. Candidate must be able to coordinate and communicate effectively with teams including legal, privacy, human resources/employee relations, security, information security, incident response, and networking professionals.

    Requirements
    • BA or BS Degree preferred or equivalent experience.
    • Certification such as CFE or CCEP or equivalent
    • 2+ years of professional experience in a technical and analytical role
    • 6+ years' experience in compliance
    • 6+ years of Corporate Fraud Investigations and/or Internal Audit Experience
    • Prepares and reviews quarterly data analysis on compliance and fraud investigations.
    • Demonstrates the ability to work with sensitive information and maintain confidentiality. Job Information
      • Job ID: 56382223
      • Position Title: Fraud Monitoring & Compliance Investigations Specialist
      • Company Name: Change Healthcare
      • Job Function: Analyst
      • Job Type: Full-Time
      • Job Duration: Indefinite
      • Min Education: BA/BS/Undergraduate
      • Min Experience: 5-7 Years
      • Required Travel: 0-10% Jobs You May Like Verizon 2025 M Street, NW, Suite 800 Washington, Dist. Columbia 20036 (202) 367-1165

Keywords: Institute for Credentialing Excellence, Alpharetta , Fraud Monitoring & Compliance Investigations Specialist, Other , Alpharetta, Georgia

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