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Senior Analyst, Fraud Waste and Abuse
CVS HealthSr. Analyst in Fraud, Waste, and Abuse at CVS Health.
Posted 6/9/2026full-timeRemote • Arizona, Idaho, Texas • 🇺🇸 United StatesSenior💰 $46,988 - $112,200 per yearWebsite
About the role
Key responsibilities & impact- Leverage analytical skills to review claims data and identify patterns of suspected potential FWA.
- At the direction of the Sr. Manager, assist in the triage, preliminary investigation of all internal and external FWA complaints
- Refer all cases of suspected FWA to regulatory agencies within required timeframes
- Assist in the monitoring of the FWA hotline and shared email box
- Participate in prepayment review process including detailed review of medical records against claims data
Requirements
What you’ll need- 3-5 years’ work experience
- CPC or equivalent coding certification
- Working knowledge of standard industry coding guidelines such as CPT, HCPCs, ICD-10
- Experience reviewing medical records to ensure that documentation matches services billed
- Experience reviewing detailed data to interpret claims data
Benefits
Comp & perks- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisclaims reviewmedical record reviewpattern identificationprepayment reviewFWA investigationdocumentation verificationdata interpretation
Soft Skills
analytical skillscommunicationattention to detailproblem-solving
Certifications
CPCcoding certification