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The Senior Specialist audits medical records and claims to assess FWA trends in healthcare, communicating findings, and training team members.

Perform end-to-end claims coding audits and repayment quality reviews using CPT/HCPCS/ICD-10 guidelines; document findings, create reference guides, support provider communications, train teammates, and drive process improvements for payment integrity.

Partner with cross-functional teams to analyze large healthcare datasets, build models and dashboards, and surface insights to reduce medical waste. Scope, run, and present analyses, monitor performance metrics, and support initiatives to improve financial and utilization outcomes.