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Change Healthcare
REMOTE, United States
22 days ago

Description

Overview of Position
Change Healthcare facilitates more than $150B in Payments to healthcare providers annually. It is imperative that we maintain secure payments processing to ensure providers receive reimbursements for the lifesaving work they do.  It is our goal to prevent payers, providers, and Change Healthcare from becoming victims of the growing Payments Fraud epidemic and help drive down the overall costs of Health Care. As a Risk Analyst, the incumbent will support enrollment teams by reviewing transactional data, decision risk alerts, and ensure compliance with regulatory and operational policies. The Risk Analyst will support adherence to the Payments Risk policies, and conduct analysis used to further develop the risk program and drive enhancements in the security of our payments solutions.  

What will be my duties and responsibilities in this job?

  • Conduct detailed monitoring of enrollment and payments operations activities to detect and prevent payments risks through transactional activity reviews. Clear alerts, restrict accounts, and initiate remediation efforts. Ensure compliance with operational policies and applicable regulatory requirements
  • Conduct in depth enrollment analysis utilizing internal and external systems, sources, and procedures to identify outliers and trends to prevent and/or identify fraud and continuously improve fraud strategy and controls.   Conduct high-risk review for indicators of fraud, communicate with providers
  • Conduct preliminary investigation of suspicious payment activity, misapplied payments, and suspected fraudulent activity, identifies/reports gaps in controls, and prepares internal reports   
  • Deep dive into individual fraud events to perform root cause analysis and breakdowns in controls to identify fraud strategy and control improvements


Requirements

  • Minimum 3 years of experience in fintech or financial services risk and fraud prevention and/or investigations
  • Experience utilizing payments industry verification tools to identify suspect transactions, resolve alerts within SLAs
  • Experience decisioning based on data and in accordance with policies and procedures, and within industry best practices

What other skills/experience would be helpful to have?

  • Bachelor’s degree preferred
  • Advanced data analysis skills using Microsoft Excel and common industry data analytic, database, and open-source information systems. SQL experience a plus
  • Stays up-to-date on industry trends and fraud detection and mitigation techniques
  • Strong analytical skills, with the ability to recognize and analyze emerging trends
  • Excellent written and verbal communication skills with the ability to prepare internal communications relevant to investigation findings
  • Identify and drive forward the use of best practices, industry standards and innovative methodologies

Job Information

  • Job ID: 63801018
  • Location:
    REMOTE, United States
  • Position Title: Payments Operations Risk Analyst
  • Company Name For Job: Change Healthcare
  • Industry: Non-banking Bank Services
  • Job Function: Analyst
  • Job Type: Full-Time
  • Job Duration: Indefinite
  • Min Education: BA/BS/Undergraduate
  • Min Experience: 3-5 Years
  • Required Travel: 0-10%

Please refer to the company's website or job descriptions to learn more about them.

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