Bilingual Junior Healthcare Fraud Investigator

Posted 4ds ago

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Job Description

Junior Fraud Investigator at Cigna supporting US Commercial Healthcare investigations with analytics and report preparation. Ideal for recent college graduates with a background in Criminal Justice.

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
  • Respond to subpoenas and requests for information from law enforcement agencies and State Departments of Insurance
  • May represent the company as a witness in judicial proceedings when appropriate
  • Prepare reports to expedite tracking and reporting of investigations

Requirements:

  • Bilingual Spanish and ability to pass oral and written assessments
  • A bachelor’s degree in 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

Benefits:

  • Health insurance
  • Professional development opportunities
  • Remote work options