Bilingual Junior Healthcare Fraud Investigator

🔥 4 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟢 Junior

💬 Bilingual

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• 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

🎯 Requirements

• Located in South Florida (Miami, homestead) and West Palm Beach area to support site visits • Bilingual Spanish • A bachelor’s 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

🏖️ Benefits

• Health insurance • Flexible work arrangements • Professional development opportunities • Paid time off