FWA Auditor

We are seeking a highly skilled Fraud, Waste & Abuse (FWA) Auditor to join our team. In this role, you will leverage your clinical expertise to review medical claims, detect inconsistencies, and ensure compliance with payer guidelines. You will play a critical part in reducing fraud, waste, and abuse while supporting our technology-driven mission to improve healthcare efficiency.

Key Responsibilities:

• Review medical claims and clinical documentation for accuracy and compliance.

• Identify potential fraud, waste, and abuse cases based on medical necessity and coding standards.

• Collaborate with product and data teams to enhance FWA detection algorithms.

• Provide clinical insight and recommendations for system improvements.

• Prepare audit reports and support client presentations when needed.

Must-Have Qualifications:

• A Medical Doctor (MD) degree is required.

• Specialty: Family Medicine, Emergency Medicine, ICU/Critical Care, or Internal Medicine.

• Minimum 3–5 years of clinical practice experience.

• Experience in medical auditing, utilization review, or payer-side claims management.

• Knowledge of FWA detection methodologies and healthcare insurance systems.

• Strong understanding of medical coding, payer rules, and clinical workflows.

• Excellent analytical and communication skills.

Nice-to-Have:

• Familiarity with healthcare technology platforms.

Why Join Us:

• Work at the intersection of healthcare and technology.

• Collaborate with a multidisciplinary team of clinicians, engineers, and product experts.

• Contribute to shaping tools that improve healthcare efficiency and integrity.

• Competitive compensation and growth opportunities.