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Entrylevel Fraud Analyst Jobs in Wisconsin (NOW HIRING)

Ethos Risk Services

Entry-Level Investigator

Milwaukee, WI

$45K - $56K/yr

Want to get paid to learn how to investigate fraud and conduct covert surveillance in the real ... Conduct preliminary investigations using social media and analyzing database research. * Field ...

Winlandfoods

Maintenance Technician

Kenosha, WI · On-site

$37.05/hr

From entry-level tasks like stocking spare parts and assisting with basic repairs to advanced ... Lead Root Cause Analysis (RCA) activities and contribute to process improvement initiatives.

Winland Foods, Inc.

Maintenance Technician

Kenosha, WI · On-site

$37.05/hr

From entry-level tasks like stocking spare parts and assisting with basic repairs to advanced ... Lead Root Cause Analysis (RCA) activities and contribute to process improvement initiatives.

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Entrylevel Fraud Analyst information

What is the difference between Entrylevel Fraud Analyst vs Entrylevel Compliance Analyst?

AspectEntrylevel Fraud AnalystEntrylevel Compliance Analyst
Required CredentialsHigh school diploma or equivalent; some roles prefer certifications like ACFE's CFCSHigh school diploma; certifications like CCEP or CAMS are common
Work EnvironmentFinancial institutions, e-commerce, insurance companiesFinancial services, healthcare, corporate compliance departments
Employer & Industry UsageUsed in banking, credit card companies, online platformsUsed in banking, healthcare, corporate sectors
Common Search & Comparison IntentYesYes

The main difference between an Entrylevel Fraud Analyst and an Entrylevel Compliance Analyst lies in their focus areas. Fraud Analysts primarily investigate and prevent fraudulent activities, while Compliance Analysts ensure adherence to laws and regulations. Both roles require similar credentials and are found in related industries like banking and finance, but their core responsibilities differ slightly.

What cities in Wisconsin are hiring for Entrylevel Fraud Analyst jobs? Cities in Wisconsin with the most Entrylevel Fraud Analyst job openings:
Entrylevel Fraud Analyst jobs near you
FRAUD WASTE ABUSE ANALYST - ASPIRUS HEALTH PLAN

FRAUD WASTE ABUSE ANALYST - ASPIRUS HEALTH PLAN

ASPIRUS HEALTH

Wausau, WI • On-site

Full-time

Medical, Retirement

Posted 26 days ago

Aspirus Health rating

6.5

Company rating: 6.5 out of 10

Based on 249 frontline employees who took The Breakroom Quiz

591st of 870 rated healthcare providers

Job description

Compassion. Accountability. Collaboration. Foresight. Joy.
These are the Aspirus Core Values; and we are looking for the BEST around to join us as we demonstrate those values Every. Single. Day.
Aspirus Health in Wausau, WI is seeking a FRAUD WASTE ABUSE ANALYST to join our ASPIRUS HEALTH PLAN team!
The FWA Analyst plays a critical role in protecting the organization from improper billing, abusive practices, and potential fraud. This position conducts detailed reviews of medical claims, provider patterns, and member activity to identify anomalies and ensure compliance with regulatory, contractual, and clinical standards.
The analyst will work closely with Senior Claims Analysts, the SIU, and cross-functional teams to support investigations, recommend corrective actions, and strengthen internal controls. A clinical background, particularly as an RN, along with utilization management and claims is strongly preferred to support accurate clinical interpretation of documentation and coding.
HOURS: Full-Time or 1.0 FTE, 80 hours every 2 weeks.
Experience/Qualifications
Required Qualifications
  • Bachelor's degree is required.
  • Active RN license is strongly preferred; LPN or other clinical credentials may be considered.
  • Minimum of two years' experience in health insurance claims analysis or related experience required.

Preferred Qualifications
  • Experience in SIU, FWA investigations, or compliance within a payer or provider environment.
  • Knowledge of CPT, HCPCS, and ICD-10 coding and medical terminology.
  • Familiarity with CMS, Medicare, and commercial plan regulations
  • Strong analytical and problem-solving skills with the ability to interpret complex data sets.
  • Excellent written and verbal communication skills for reporting and cross-department collaboration.
  • Proficiency with claims platforms and data tools such as Facets, ClaimsXten, Excel, or similar systems.
  • Background in clinical case management or utilization review.

Employee Benefits
  • Full benefits packages available for part- and full-time status.
  • Time away from work accrual.
  • Retirement plans available.
  • Wellness program for employees and their families.

Our Mission: We heal people, promote health and strengthen communities.
Our Vision: Aspirus is a catalyst for creating healthy, thriving communities, trusted and engaged above all others.
As an Aspirus team, we demonstrate caring, we plan to impact the future, work with happiness and enthusiasm, recognize our power to make a difference and improve the health of our communities.
Aspirus Health is a nonprofit, community-directed health system based in Wausau, Wisconsin, serving northeastern Minnesota, northern and central Wisconsin and the Upper Peninsula of Michigan. The health system operates 18 hospitals and 130 outpatient locations with nearly 14,000 team members, including 1,300 employed physicians and advanced practice clinicians. For more information visit aspirus.org.
Click here to learn more.

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