The Cigna Group · 6 hours ago
Healthcare Fraud Investigator - Remote
United States
Full-time
Remote
Mid Level
$65K/yr - $108K/yr
3+ years exp
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Responsibilities
Analyze information gathered by investigation/audit and report findings and prepare written summary/recommendations
Prepare evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies
Leads on-site inspections and patient/provider interviews as necessary
Respond to subpoenas and requests for information from law enforcement agencies and State Departments of Insurance. May represent company as a witness in judicial proceedings when appropriate
Performs special projects requiring expertise in fraud detection, investigation, claim auditing and other areas related to Special Investigations
Prepare reports to expedite tracking and reporting of investigations
Qualification
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Required
3+ years’ experience in health insurance fraud investigation/audit
Associate's Degree required
Clear and concise verbal and written communication skills
Strong computer skills are required – Excel, Access and Word
Strong attention to detail, analytical & critical thinking skills
Preferred
Bachelor’s Degree in Criminal Justice or related field strongly preferred
Experience with leading investigations, data analysis, report writing, presenting findings highly preferred
Accredited Health Care Fraud Investigator (AHFI) certification and Certified Fraud Examiner (CFE) preferred
Benefits
Medical
Vision
Dental
Well-being and behavioral health programs
401(k) with company match
Company paid life insurance
Tuition reimbursement
A minimum of 18 days of paid time off per year
Paid holidays
Company
The Cigna Group
The Cigna Group is a healthcare firm that focuses on providing hospital services and innovative solutions for better health.
10,001+ employees
Funding
Current Stage
Late StageLeadership Team
David Cordani
Chairman and Chief Executive Officer
Recent News
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