Senior Analyst, Fraud Waste and Abuse

Sr. 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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

data analysisclaims reviewmedical record reviewpattern identificationprepayment reviewFWA investigationdocumentation verificationdata interpretation

Soft Skills

analytical skillscommunicationattention to detailproblem-solving

Certifications & Qualifications

CPCcoding certification

Industry Keywords

FWACPTHCPCsICD-10regulatory compliance

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

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

Comp & perks