Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home
The job profile for this position is Fraud Senior Analyst, which is a Band 3 Senior Contributor Career Track Role.
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
Bilingual Spanish Junior Healthcare Fraud Investigator:
Are you ready to launch your Healthcare Fraud Investigator career and make a real difference? If you're a recent college graduate eager to take the first step in your professional journey, this earlyâcareer opportunity is designed for you.
This 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 Cigna's Special Investigations Unit, youâll 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.
What youâll do:
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
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
Prepare reports to expedite tracking and reporting of investigations
What you need to do the job:
Bilingual Spanish and ability to pass oral and written assessments
A bachelorâs degree in a Criminal Justice, or related field
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.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Apply To This Job
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
Bilingual Spanish Junior Healthcare Fraud Investigator:
Are you ready to launch your Healthcare Fraud Investigator career and make a real difference? If you're a recent college graduate eager to take the first step in your professional journey, this earlyâcareer opportunity is designed for you.
This 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 Cigna's Special Investigations Unit, youâll 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.
What youâll do:
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
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
Prepare reports to expedite tracking and reporting of investigations
What you need to do the job:
Bilingual Spanish and ability to pass oral and written assessments
A bachelorâs degree in a Criminal Justice, or related field
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.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Apply To This Job