• Proactively detect and reacquire bad actors on our platform. • Investigate potentially policy-violating activity by querying internal data sources (using SQL and Python) and cross-referencing open source information (OSINT). • Document and share investigative findings with internal stakeholders.

• Conduct comprehensive reviews of medical records and documents supporting claims for providers, suppliers, and pharmacies • Provides investigative support to the Special Investigations Unit (SIU) related to coding and billing issues • Identifies potential overpayments and suspected health care fraud and abuse • Verifies authorization for services and written documentation of services provided against claim information • Ensures the appropriateness and accuracy of diagnosis and procedure codes supporting such claims • Coordinates medical necessity and appropriate level of care determinations with Medical Directors • Validates services against CMS and State-specific coverage, limitations and exclusion guidelines • Coordinates with internal and external resources to determine the appropriateness of codes • Develops reports of findings and recommendations • Communicates complex results of audit findings in meetings and/or judicial hearings • Assists SIU investigators during interviews, discussions and negotiations • Performs retrospective and prepayment reviews of medical records to identify potential fraud, waste, and abuse • Investigates, analyzes, and identifies provider billing patterns • Prepares summary of findings and recommends next steps for providers • Identifies preventative measures and recommends changes to internal policies and procedures and/or provider practices

• Serve as a financial member of the Project Team with the goal to contribute towards timely, efficient, and accurate preparation and tracking of site payments • Review the financial section of the Clinical Trial Agreement (CTA) to prepare the tracking workbook for site payments on a project-by-project and site-by-site basis • Responsible for maintaining the advance balance tracking on a project-by-project basis to ensure that sufficient prepaid funds are on-hand to make site payments • Work with the respective Project Directors and Project Managers to provide guidance on how to populate the site payment workbook to ensure visits eligible for payment are tracked and processed • Ensure that the investigator site payment workbook is financially calculating all fields correctly to facilitate accurate site payments • Prepare the site payment package for the Project Director/Project Manager review and approval • Communicate approved payments based upon the terms and conditions of the CTA within the Finance Department and this step will facilitate entry into the financial systems and payment processing • Preparation of Aggregate Spend (Sunshine Act) Medicare/Medicaid (MMSE) reporting as applicable • Preparation of site payment reconciliations • Maintenance of the investigator grant dedicated mailbox • Coach and Mentor teammates on Investigator Grants Team • Ad hoc financial tasks and duties as assigned by the Senior Manager, Global Investigator Grants • Provides support to the Project Team by managing the Investigator Grants pass through budget. • Ability to collect data pertaining to patient activity at each site in the workbook use this data to: • Create accurate client accrual • Pay sites based on Fully Executed Clinical Trial Agreement • Project costs to monitor overall budget health • Ability to communicate with sites and clients via email to resolve inquiries. • Exhibits self-motivation, is detail-oriented and able to work and plan independently as well as in a team environment • Ability to deliver on commitments, an understanding of the service culture and positive interactions with customers and teammates

• Serve as a financial member of the Project Team with the goal to contribute towards timely, efficient, and accurate preparation and tracking of site payments • Review the financial section of the Clinical Trial Agreement (CTA) to prepare the tracking workbook for site payments on a project-by-project and site-by-site basis • Responsible for maintaining the advance balance tracking on a project-by-project basis to ensure that sufficient prepaid funds are on-hand to make site payments • Work with the respective Project Directors and Project Managers to provide guidance on how to populate the site payment workbook to ensure visits eligible for payment are tracked and processed • Ensure that the investigator site payment workbook is financially calculating all fields correctly to facilitate accurate site payments • Prepare the site payment package for the Project Director/Project Manager review and approval • Communicate approved payments based upon the terms and conditions of the CTA within the Finance Department and this step will facilitate entry into the financial systems and payment processing • Preparation of Aggregate Spend (Sunshine Act) Medicare/Medicaid (MMSE) reporting as applicable • Preparation of site payment reconciliations • Maintenance of the investigator grant dedicated mailbox • Coach and Mentor teammates on Investigator Grants Team • Ad hoc financial tasks and duties as assigned by the Senior Manager, Global Investigator Grants • Provides support to the Project Team by managing the Investigator Grants pass through budget. • Ability to collect data pertaining to patient activity at each site in the workbook use this data to: • Create accurate client accrual • Pay sites based on Fully Executed Clinical Trial Agreement • Project costs to monitor overall budget health • Ability to communicate with sites and clients via email to resolve inquiries. • Exhibits self-motivation, is detail-oriented and able to work and plan independently as well as in a team environment • Ability to deliver on commitments, an understanding of the service culture and positive interactions with customers and teammates