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Healthcare Fraud Investigator
1 month ago
Job Summary:
We are seeking a skilled Investigative Analyst II to join our team at Elevance Health. As a key member of our Payment Integrity department, you will play a critical role in identifying, investigating, and developing cases against perpetrators of healthcare fraud.
Key Responsibilities:
- Conduct in-depth claim reviews to identify potential fraud and abuse
- Develop and implement investigative strategies to recover corporate and client funds
- Collaborate with law enforcement agencies to effectively establish rapport and working relationships
- Interface with senior-level management and legal departments throughout the investigative process
- Assist in training internal and external entities on investigative procedures and policies
Requirements:
- Bachelor's degree in a related field (e.g., healthcare administration, business, or a related field)
- Minimum 3 years of experience in a related field, with a focus on healthcare fraud investigation or a related field
- Fraud certification from CFE, AHFI, AAPC, or coding certificates preferred
- Knowledge of plan policies and procedures in all facets of benefit programs management, with a heavy emphasis on negotiation
- Health insurance and law enforcement experience preferred
What We Offer:
- A competitive salary and benefits package
- Opportunities for professional growth and development
- A dynamic and supportive work environment
- The chance to make a meaningful impact in the healthcare industry
How to Apply:
Please submit your resume and cover letter to [insert contact information]. We look forward to hearing from you