Senior Investigator

Min 5 yrs required

Full-time

No

Job Title: Senior Investigator

Salary: Not specified

Experience: Minimum of 5 years in healthcare insurance and investigation, law enforcement or related field

Location: Indiana, Indianapolis; Maryland, Hanover; Ohio, Columbus; Rhode Island, Smithfield; Florida, Tampa; New Jersey, Iselin; Virginia, Richmond; Illinois, Chicago; Georgia, Atlanta

Company: Elevance Health

Department: Carelon Payment Integrity

H1: Senior Investigator at Elevance Health

H2: Join our team and make a difference in healthcare.

Bullets:

- Full-time position with a hybrid work model (remote and office)
- Ideal candidate will live within 50 miles of an Elevance Health location
- Responsible for identifying, investigating, and developing complex cases of healthcare fraud
- Recover corporate and client funds from fraudulent claims
- Conduct claim reviews and data mining
- Interface with senior level management and legal department
- Assist in training internal and external entities
- Develop policies and procedures to prevent loss of company assets
- Represent company in court proceedings
- Health insurance experience required
- Develop and maintain relationships with law enforcement and regulatory agencies
- Minimum of 5 years experience in healthcare insurance and investigation, law enforcement, or related field
- Proficient in Microsoft Excel
- Professional certification preferred
- Knowledge of health insurance policies, claims handling, and provider network contracting preferred
- Elevance Health only accepts resumes from agencies with a signed agreement
- Fortune 25 company with a strong commitment to improving lives and communities
- Values and behaviors drive culture and promote personal and professional growth
- Competitive total rewards package including merit increases, paid holidays, Paid Time Off, and incentive bonus programs
- Hybrid workforce strategy with some work required at an Elevance Health location
- Candidates must reside within 50 miles or 1-hour commute of a relevant Elevance Health location
- COVID-19 vaccination required for certain patient/member-facing roles
- Equal Employment Opportunity employer with a commitment to diversity and inclusion
- Accommodations available for those in need during the application process.

Not specified

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

Not specified

Microsoft Excel, Communication, Analytical Thinking, Legal Knowledge, Negotiation, Healthcare Industry Knowledge

Not specified

Submit resume to

Qualification and Experience BA/BS

Legal