Forensic Accountant - Healthcare

Vivo HealthStaff
  • Nashville, TN
  • Contractor
  • Quick Apply
15 days ago

Job Description

Forensic Accountant - HealthcareWe are seeking an experienced Forensic Accountant to join our Healthcare practice. In this role, you will investigate complex financial matters within healthcare organizations-including hospitals, physician groups, payers, and life sciences companies-and translate your findings into clear, defensible analysis that supports litigation, regulatory inquiries, and dispute resolution.The ideal candidate combines deep healthcare financial expertise with hands-on litigation experience and a working command of modern AI and large language model (LLM) tools used to accelerate document review, data analysis, and reporting. You will work closely with attorneys, expert witnesses, compliance teams, and clients to reconstruct financial events, quantify damages, and uncover irregularities.Key ResponsibilitiesConduct forensic investigations into healthcare billing, coding, reimbursement, revenue cycle, and cost-reporting matters, including potential fraud, waste, and abuse.Analyze large, complex financial and claims datasets to identify anomalies, quantify damages, and reconstruct transactions.Support litigation and dispute matters, including preparing schedules, exhibits, and expert report content, and assisting with deposition and trial preparation.Investigate allegations involving False Claims Act, Stark Law, Anti-Kickback Statute, payer/provider disputes, M&A disputes, and contractual underpayment or overpayment.Apply AI/LLM tools to accelerate document review, summarize evidence, draft work product, and surface patterns across unstructured records-while validating outputs for accuracy and defensibility.Interpret healthcare contracts, fee schedules, and reimbursement methodologies (e.g., DRG, RVU, fee-for-service, capitation, value-based arrangements).Prepare clear written reports and findings suitable for counsel, regulators, and the courts.Collaborate with multidisciplinary teams of attorneys, data analysts, clinicians, and compliance professionals.Maintain meticulous documentation and chain-of-custody standards to ensure findings are evidence-based and admissible.Required QualificationsActive CPA license (in good standing).Demonstrated healthcare industry experience, with working knowledge of healthcare billing, coding, reimbursement, and regulatory frameworks.Litigation experience, including supporting expert reports, damages calculations, depositions, and/or testimony in a forensic or dispute context.Hands-on experience with AI/LLM tools applied to financial analysis, document review, or investigative workflows.Strong analytical skills with the ability to work with large, complex, and unstructured datasets.Excellent written and verbal communication skills, including the ability to explain technical findings to non-technical audiences.High standard of professional integrity, objectivity, and attention to detail.Preferred QualificationsAdditional forensic or fraud credentials (e.g., CFE, CFF, ABV, MAFF).Experience with healthcare-specific data sources and claims systems (e.g., 837/835 EDI, CMS data, EHR/practice management exports).Familiarity with the False Claims Act, Stark Law, Anti-Kickback Statute, and HIPAA.Proficiency with data analytics and visualization tools (e.g., SQL, Python, Power BI, Tableau, Alteryx).Experience prompting, evaluating, and validating LLM outputs for accuracy, bias, and reliability in a professional setting.Prior experience in a public accounting, consulting, or expert-services environment.

Numbers & Facts

LocationNashville, TN
Job TypeContractor

Skills

  • Analysis Skillsunmatched
  • Artificial Intelligence (AI)unmatched
  • Artificial Intelligence (AI) Programming Languagesunmatched
  • Biologyunmatched
  • Certified Financial Examiner (CFE)unmatched
  • Certified Public Accountant (CPA)unmatched
  • Communication Skillsunmatched
  • Consultingunmatched
  • Content Management Systems (CMS)unmatched
  • Contract Analysisunmatched
  • Cost Reportingunmatched
  • Cross-Functionalunmatched
  • Data Analysisunmatched
  • Data Setsunmatched
  • Data Visualization Toolsunmatched
  • Detail Orientedunmatched
  • Diagnosis-Related Group (DRG)unmatched
  • Documentationunmatched
  • Documentation Reviewunmatched
  • Electronic Data Interchange (EDI)unmatched
  • Fee Scheduleunmatched
  • Financial Analysisunmatched
  • Forensic Accountingunmatched
  • HIPAA (Health Insurance Portability and Accountability Act)unmatched
  • Healthcareunmatched
  • Healthcare Reimbursementunmatched
  • Hospitalunmatched
  • Legalunmatched
  • Litigationunmatched
  • Medical Billingunmatched
  • Medical Record Systemunmatched
  • Mergers and Acquisitionsunmatched
  • Modeling Languagesunmatched
  • Power BIunmatched
  • Presentation/Verbal Skillsunmatched
  • Public Accountingunmatched
  • Python Programming/Scripting Languageunmatched
  • Regulationsunmatched
  • Relative Value Unit (RVU)unmatched
  • Reporting Skillsunmatched
  • SQL (Structured Query Language)unmatched
  • Statutory Lawsunmatched
  • Tableauunmatched
  • Writing Skillsunmatched

Be found by employers

5,500+ employers search our resume database daily. Add yours to get found by recruiters looking for candidates like you.

Level up your application

Professional resume templates

Browse dozens of recruiter approved resume templates, layouts and formats. Choose your favorite and make it your own in minutes.

Free resume templates

Free resume builder

Improve your existing resume or start from scratch and create a standout, ATS-friendly resume. Add job-specific content, download and apply.

Free resume builder