Bluespine-Medical Fraud & Anomaly

Description:

Bluespine is looking for curious, analytical, and highly motivated individuals to join our Medical Fraud & Anomaly Research team.

In this role, you will leverage Bluespine's proprietary Insights Platform to investigate healthcare claims, identify unusual billing patterns, uncover potential fraud and payment anomalies, and turn data into meaningful findings for our customers.

This is not a traditional medical or data analyst position. We are looking for natural investigators people who enjoy solving complex problems, connecting the dots, challenging assumptions, and digging deeper to understand why something doesn't make sense.

What You'll Do

• Leverage Bluespine's Insights Platform to investigate medical claims, analyze billing patterns, and identify potential fraud, anomalies, and payment inconsistencies across our customers.
• Investigate and validate findings, distinguishing meaningful anomalies from statistical noise, normal variations, and legitimate exceptions.
• Connect the dots and expand investigations, turning individual findings into broader investigative opportunities, recurring patterns, and scalable detection concepts.
• Conduct independent research using medical literature, publicly available information, and multiple data sources to support investigations.
• Present clear, evidence-based findings, explaining the underlying analysis, supporting evidence, potential implications, and recommended next steps.
• Contribute to improving detection capabilities by sharing investigative insights and identifying opportunities to enhance Bluespine's platform.
• Collaborate with experienced analysts and medical experts to investigate complex cases.

• Current student or recent graduate in Medical Sciences, Life Sciences, Biology, Neuroscience, Bioinformatics, Data Science, or another analytical or research-oriented field.
• Alternatively, a background in intelligence research, analytical military service, fraud investigation, or similar investigative work.
• Experience investigating anomalies, fraud, or unusual behavioral patterns in data-driven sectors such as FinTech, healthcare, insurance, financial services, or cybersecurity.
• Strong analytical thinking and problem-solving abilities.
• Natural curiosity and a passion for research, investigation, and discovering patterns.
• Ability to connect information, identify inconsistencies, and think beyond the obvious.
• Independent learning skills and a proactive, self-driven approach.
• Comfortable working with data, technology, and AI-powered tools.
• Strong English reading and writing skills.

Nice to Have

• Experience in military intelligence, research, or investigative roles.
• Academic or practical experience in medical or scientific research.
• Familiarity with SQL, Python, Excel, or data analysis tools.
• Interest in medicine, healthcare systems, or medical technologies.
• Prior experience in US healthcare, medical billing, or insurance claims