Claims Specialist

Title: Claims Specialist
Location: 906 Adobe St, Los Angeles, CA 90012 (Onsite)
Duration: 04-08weeks contract

Job Summary:
Responsible for reviewing, analyzing, and optimizing Fraud, Waste, and Abuse (FWA) case dispositions for client. The role focuses on improving case accuracy, prioritizing open investigations, and developing a roadmap to resolve backlog and strengthen case management processes.

Key Responsibilities:

• Review and assess FWA case files, documentation, and disposition rationale.
• Identify discrepancies, misclassifications, and process gaps.
• Recommend updated dispositions and categorize cases by severity and risk.
• Prioritize open and unresolved cases using defined risk and impact criteria.
• Develop a phased roadmap to address backlog and enhance future case workflows.
• Prepare detailed reports and executive summaries with key insights and recommendations.