Cigna Remote Jobs | Healthcare Work from home Jobs Online Applied for Beginners

By | April 13, 2022

Job Responsibilities : Healthcare Fraud Investigator – Work from home

Salary : $62,800 – $104,600 a year

Company : Cigna

Location : Remote US

Join our Special Investigations Unit as a Fraud Investigator supporting our US Commercial Healthcare Business r esponsible for conducting and supporting audits and investigations of potentially fraudulent claim activity by providers. You will bring complex investigative and analytic skills that include planning developing and implementing investigative processes and procedures. You will make recommendations for potential corrective actions that include prosecution recovery and/or litigation based on investigative findings.

Key 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
  • Lead on-site inspections and patient/provider interviews as necessary
  • Respond 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
  • Perform special projects requiring expertise in fraud detection investigation claim auditing and other areas related to Special Investigations
  • Prepare reports to expedite tracking and reporting of investigations

Minimum Requirements:

  • Minimum 3 years’ experience in health insurance investigation/audit
  • Bachelor’s Degree in Criminal Justice or related field strongly preferred
  • Clear and concise verbal and written communication skills
  • Strong computer skills are required – Excel Access and Word
  • Accredited Health Care Fraud Investigator (AHFI) certification and Certified Fraud Examiner (CFE) preferred

Click Here : Apply Now