[Remote] Healthcare Investigator-Fraud Lead Analyst-Remote

Remote Full-time
Note: The job is a remote job and is open to candidates in USA. Cigna Healthcare is dedicated to improving the health and vitality of those they serve. They are seeking a Healthcare Investigator to lead in-depth investigations into suspected or confirmed fraud impacting customers or the company, utilizing strong judgment and independence to drive cases toward resolution. Responsibilities • Conduct interviews, research, and analysis to resolve fraud allegations • Manage complex, high-dollar investigations with minimal supervision • Prepare detailed reports and evidence packages for insurance fraud bureaus, contract holders, and law enforcement • Coordinate investigations with local, state, and federal agencies • Respond to subpoenas and regulatory requests; provide testimony when needed • Support special projects involving fraud detection, auditing, and investigative best practices • Partner with internal departments while maintaining strict confidentiality standards Skills • Bachelor's degree in Criminal Justice or related field or 7+ years of investigative claims experience • Excellent written and verbal communication skills • Ability to adapt quickly to changing priorities and work independently • 3+ years of health insurance investigation or audit experience strongly preferred • Strong computer and analytical skills; proficiency in Microsoft Excel, Access, and Word preferred Benefits • Medical • Vision • Dental • Well-being and behavioral health programs • 401(k) • Company paid life insurance • Tuition reimbursement • A minimum of 18 days of paid time off per year • Paid holidays Company Overview • We are a health benefits provider that advocates for better health through every stage of life. It was founded in 1982, and is headquartered in Bloomfield, CT, US, with a workforce of 10001+ employees. Its website is Apply tot his job
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Entry-Level Data Entry Clerk – Part-time / Full-time Opportunity for Career Growth and Development in a Supportive and Forward-Thinking Team Environment

Remote

Entry Level Technical Support Specialist for Content Creation Teams at Blithequark – Remote Opportunity for Career Growth and Development

Remote

Lead Generation Representative

Remote

**Experienced Customer Care Representative – Entry-Level Opportunity at arenaflex**

Remote

Data Analytics Lead- Legal Operations

Remote

**Customer Engagement Manager – arenaflex Store**

Remote

**Experienced Remote Customer Service Representative – Delta Airlines – Work from Home Opportunity**

Remote

Associate Site Merchandiser (Hybrid)

Remote

PRN Home Infusion Nurse

Remote

**Experienced Full Stack Strategic Sourcing Specialist – Professional Services Sourcing and Contract Negotiation**

Remote
← Back