Mass General Brigham · 6 hours ago
Fraud Analyst
Somerville-MA
Full-time
Hybrid
Entry, Mid Level
$62K/yr - $91K/yr
2+ years expMass General Brigham is a not-for-profit organization that supports patient care, research, teaching, and community service. They are seeking a Fraud Analyst to build data analytics for the Special Investigations Unit, focusing on identifying fraudulent claims through data analysis and reporting.
Health CareHome Health CareMedical
Responsibilities
Develop and run reports, analyze data to identify suspicious billing patterns, assess the merits of allegations, and present those findings to leadership
Analyze claims data to find suspicious billing patterns and outliers, using knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerabilities
Conduct preliminary investigations to assess the merits of allegations through fact-gathering and analyses of data sets
Organize data and document preliminary investigative steps with a high level of detail and accuracy to clearly and concisely support investigative inferences, conclusions, and recommendations
Report discoveries of fraud or program abuse to external parties, as required by law, rule, or contract
Receive investigative requests from field staff, internal claims associates, and underwriting
Qualification
Required
Bachelor's Degree
At least 2-3 years of experience investigating claims or compliance required
At least 2-3 years of experience as an analyst in healthcare, data reporting or data analysis required
Strong verbal/written communication skills
Excellent analytical, critical thinking, and organizational skills
Comprehensive knowledge of CPT, HCPCS, ICD10-CM diagnosis, and procedure codes
Strong aptitude for technology-based solutions
Ability to develop, introduce, defend, and gain support for new ideas and approaches
Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy
Preferred
Healthcare fraud experience highly preferred
Data analysis with SQL proficiency highly preferred
Benefits
Comprehensive benefits
Career advancement opportunities
Differentials
Premiums and bonuses as applicable
Recognition programs designed to celebrate your contributions and support your professional growth
Company
Mass General Brigham
Mass General Brigham specializes in providing medical treatments and health diagnostics services.
10001+ employees
H1B Sponsorship
Mass General Brigham has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
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Trends of Total Sponsorships
2025 (77)
2024 (61)
2023 (93)
2022 (70)
2021 (80)
2020 (29)
Funding
Current Stage
Late StageLeadership Team
E
Erin Flanigan
SVP, Human Resources, Community, Specialty Hospital Division
O’Neil A. Britton
Chief Integration Officer, Executive Vice President
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