Investigator II

4 days ago


Durham, North Carolina, United States Elevance Health Full time
About the Role

We are seeking a skilled Investigator II to join our team at Elevance Health. As a key member of our healthcare fraud investigation team, you will play a critical role in identifying, investigating, and developing cases against perpetrators of healthcare fraud.

Key Responsibilities
  • Conduct thorough claim reviews to identify potential healthcare fraud
  • Develop and implement investigative strategies to recover corporate and client funds
  • Collaborate with law enforcement agencies to establish rapport and working relationships
  • Interface with senior management and legal departments to ensure effective investigative processes
  • Assist in training internal and external entities on healthcare fraud investigation and prevention
Requirements
  • Bachelor's degree in a related field (e.g., healthcare administration, business, or law)
  • Minimum 3 years of experience in 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
What We Offer

At Elevance Health, we offer a range of market-competitive total rewards, including merit increases, paid holidays, and incentive bonus programs. We also provide a comprehensive benefits package, including medical, dental, vision, and 401(k) + match. Our company culture values personal and professional growth, and we offer opportunities for training and development to help you advance your career.

We are an Equal Employment Opportunity employer and welcome applications from diverse candidates. If you require accommodation to participate in the job application process, please contact us for assistance.


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