Junior Healthcare Fraud Analyst-Remote

Bloomfield, CT - USA

Monthly Salary: Not Disclosed

Posted on: 16 hours ago

Vacancies: 1 Vacancy

Job Summary

Are you ready to launch your Healthcare Fraud Investigator career and make a real difference If youre a recent college graduate eager to take the first step in your professional journey this earlycareer 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 Cignas Special Investigations Unit youll 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 youll 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:

A bachelors 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.

For this position we anticipate offering an annual salary of 56700 - 94500 USD / yearly depending on relevant factors including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll be offered several health-related benefits including medical vision dental and well-being and behavioral health 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 details on our employee benefits programs click here.

About The Cigna Group

Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group were dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. Join us in driving growth and improving lives.

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.

If you require reasonable accommodation in completing the online application process please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama Alaska Arizona Arkansas Delaware Florida Georgia Hawaii Idaho Iowa Kansas Maryland Massachusetts Michigan Nebraska Ohio Pennsylvania Texas Utah Vermont and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal state and local ordinances.

Required Experience:

Junior IC