The Sr. Fraud Advisor is responsible for delivering expert fraud prevention and compliance support to clients, ensuring adherence to regulatory standards, and driving operational excellence
Job Summary
The Sr. Fraud Advisor is responsible for delivering expert fraud prevention and compliance support to clients, ensuring adherence to regulatory standards, and driving operational excellence.
Key responsibilities include managing audits, client consultations, reporting, and compliance activities while serving as a trusted advisor on fraud-related matters.
The company culture is built on collaboration, inclusivity, and continuous improvement, fostering an environment where every voice matters and integrity guides every decision.
Matching Summary
The Sr. Fraud Advisor is responsible for delivering expert fraud prevention and compliance support to clients, ensuring adherence to regulatory standards, and driving operational excellence.
Skills & Requirements
Must-have
Client consultation and guidance
Perform client and internal audits
Prepare and deliver client reports
Issue commercial alerts and notifications
Manage RFIs and support RFPs
Respond to ad-hoc client requests
Nice-to-have
Collaborative and inclusive culture
Continuous improvement and innovation
Honesty, trust, and transparency
Belonging and engagement
Key Requirements
Bachelor's degree in Healthcare Administration, Business, Criminal Justice, or related field
Minimum 5+ years in healthcare fraud prevention, compliance, or auditing
Experience with CMS audits, Medicare/Medicaid programs
Proficiency in Microsoft Excel and reporting tools
Certified Fraud Examiner (CFE) or similar preferred