Investigator Senior

Min 5 yrs required

Full-time

No

Job Title: Investigator Senior - Healthcare Fraud

Salary: Competitive salary based on experience

Experience: Minimum 5 years in healthcare insurance and investigation

Location: Hybrid (remote and office) within 50 miles of Elevance Health PulsePoint locations

Department: Fraud Investigation

H1: Join Our Team as an Investigator Senior in Healthcare Fraud

H2: Make an Impact with Elevance Health

Bullet Points:

- Conduct investigations against perpetrators of healthcare fraud
- Utilize coding reviews, data mining, and proprietary systems to review claims
- Develop and maintain relationships with law enforcement and regulatory agencies
- Assist in the development of policies and procedures to prevent loss of company assets
- Represent the company in court proceedings
- Must have 5 years of experience in healthcare insurance and investigation
- Professional certification preferred
- Knowledge of health insurance policies and procedures preferred
- Competitive salary and benefits package offered
- Hybrid work model with required on-site work at Elevance Health locations
- COVID-19 vaccination required for certain patient/member-facing roles
- Elevance Health is an Equal Employment Opportunity employer

Bold Headlines:

- Investigator Senior position available at Elevance Health
- Join our team and make an impact in healthcare fraud investigation
- Competitive salary and benefits package offered
- Hybrid work model with remote and on-site work
- COVID-19 vaccination required for certain roles
- Equal Employment Opportunity employer

Medical, Dental, Vision, Short and Long Term Disability, 401(k) + match, stock purchase plan, life insurance, wellness programs, financial education resources

Claim Reviews, Data Mining, Entity Review, Law Enforcement Referral, Proprietary Data, Claim Systems, Research, Communication, Negotiation, Policy Development, Training, Court Proceedings, Rapport Building

BA/BS in related field

Submit resume to

Qualification and Experience BA/BS in related field, 5+ years experience in healthcare insurance and investigation or equivalent combination of education and experience

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