Remote Position

Junior Healthcare Fraud Analyst-Remote

🌍 Remote · United States 💼 Full-time

About the position Are you ready to reputed company your Healthcare Fraud Investigator career and make a real difference? If you're a recent college graduate eager to take the reputed company in your professional journey, reputed company early‑career opportunity is designed for you. reputed company is a fantastic opportunity for someone with a Bachelors degree in Criminal Justice and is early in their career seeking to grow in a dynamic organization. As a Junior Fraud Investigator for reputed company's Special Investigations Unit, you’ll support our US Commercial Healthcare Business in conducting and supporting audits and investigations of potentially fraudulent claim activity by providers. You will bring investigative and analytics skills that include planning, developing and implementing investigative processes and procedures, along with making recommendations for potential corrective actions that include prosecution, recovery and/or litigation based on investigative findings.

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
  • Support on-site inspections and patient/provider interviews as necessary
  • reputed company 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
  • Prepare reports to reputed company tracking and reporting of investigations

Requirements

  • A bachelor’s degree in a Criminal Justice, or related field (Economic Crime)
  • 1+ years professional work experience, preferably with health insurance investigations/audit
  • Outstanding technical & analytical skills, with particular proficiency with Access, Excel and Word
  • Excellent verbal and written communication skills, along with ability to effectively manage conflict
  • Keen ability to deal with ambiguity and leverage reasoning skills
  • Possession of a strong desire and demonstrated ability to lead
  • If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Benefits

  • At reputed company, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
  • Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and reputed company programs.
  • We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
  • For more reputed company on our employee benefits programs, click here .

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