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Investigator
4 weeks ago
Elevance Health is seeking a skilled Investigator I to join our team. As an Investigator I, you will play a critical role in detecting and preventing fraudulent activities in our healthcare insurance programs.
Key Responsibilities:- Conduct thorough investigations of assigned cases to identify and prevent fraudulent, abusive, or wasteful activities.
- Analyze claim data and review professional and facility claims to detect potential issues.
- Prepare statistical and financial analyses and reports to document findings and maintain up-to-date electronic case files.
- Communicate findings to management and stakeholders, including providers and subscribers.
- Collaborate with internal teams to develop and implement strategies to prevent and detect fraud.
- Bachelor's degree in a related field, such as healthcare administration or business.
- Minimum of 2 years of experience in a related field, such as healthcare insurance, law enforcement, or compliance.
- Fraud certification from a recognized organization, such as CFE or AHFI, is preferred.
- A competitive salary and benefits package.
- Opportunities for professional growth and development.
- A dynamic and supportive work environment.
Elevance Health is an Equal Employment Opportunity employer and welcomes applications from diverse candidates. If you are passionate about making a difference in the healthcare industry and have the skills and experience to succeed in this role, we encourage you to apply.