Senior Investigator

Min 5 yrs required

Full-time

No

SEO-Friendly Job Title: Senior Investigator (Investigator Sr) - Healthcare Fraud Recovery

H1: Join Our Team as a Senior Investigator at Elevance Health!

H2: Responsible for Identifying and Investigating Healthcare Fraud



Bold Headlines:

- Senior Investigator position at Elevance Health available
- Full-time position with hybrid work model (remote and office)
- Ideal candidate should live within 50 miles of Elevance Health PulsePoint locations
- Member of Carelon Payment Integrity, determined to recover, eliminate, and prevent unnecessary medical-expense spending
- Responsible for identifying, investigating, and developing complex cases against perpetrators of healthcare fraud
- Impactful role with involvement in claim reviews, law enforcement referrals, and policy development
- Required experience in health insurance with understanding of policies, claims handling, and provider network contracting
- Minimum of 5 years related experience required
- Preferred skills include proficiency in Microsoft Excel, professional certification, and knowledge of plan policies and procedures
- Elevance Health only accepts resumes from agencies with a signed agreement
- Fortune 25 company with a culture focused on personal and professional growth
- Offers market-competitive total rewards including medical, dental, vision, and 401(k) match
- Operates in a hybrid workforce strategy, with some onsite work required
- COVID-19 vaccination requirement for certain patient/member-facing roles
- Equal Employment Opportunity employer, accommodations available for job application process.

Not specified.

Medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources.

Not specified.

Data analysis, interviewing, law enforcement, negotiation, policy development, claim system review, Microsoft Excel, CFE, AHFI, CPC, Paralegal, RN, JD.

BA/BS degree.

Submit resume to .

Qualification and Experience BA/BS degree, 5 years of experience in healthcare insurance and investigation or related fields.

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