A company is looking for a Prevention & Control Specialist to monitor transportation benefit programs for fraud and compliance.
Key Responsibilities Conduct outreach to healthcare facilities to verify member rides and claims Investigate potential fraud by reviewing reports and documenting findings Utilize data management tools to track and analyze fraud investigation data Required Qualifications High school diploma or equivalent 1+ year in customer service or healthcare operations Familiarity with Medicaid/Medicare or healthcare operations Open to travel 10% of the time Comfortable learning and using operational technical systems