Investigator I
1 month ago
We are seeking a skilled Investigator I to join our team at Elevance Health. As a key member of our healthcare insurance department, you will be responsible for investigating assigned cases, collecting and analyzing claim data to detect fraudulent, abusive, or wasteful activities.
Key Responsibilities- Investigate assigned cases to detect and prevent healthcare insurance fraud, abuse, and waste.
- Collect and analyze claim data to identify trends and patterns.
- Prepare statistical and financial analyses to document findings and maintain up-to-date electronic case files.
- Communicate findings to management and stakeholders.
- Bachelor's degree in a related field.
- Minimum of 2 years of experience in healthcare insurance, law enforcement, or a related field.
- Fraud certification from CFE, AHFI, AAPC, or coding certificates preferred.
Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
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Healthcare Investigator
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Durham, North Carolina, United States Elevance Health Full timeJob Summary:The Healthcare Investigator I role at Elevance Health involves investigating assigned cases to detect fraudulent, abusive, or wasteful activities/practices in healthcare insurance payments to providers and subscribers.Key Responsibilities:Utilize system tools and databases to analyze data and review professional and facility claims.Prepare...
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