Auditor/Investigator I

Job Summary

To ensure the integrity and accuracy of claims processes, the full-time hourly Auditor/Investigator I will conduct audits and investigations into customer claims, utilizing analytical skills to assess validity and identify potential fraud, waste, and abuse in a remote work environment.

Key responsibilities

• Conduct routine audits and investigations into customer claims to ensure accurate assessments of claims validity
• Compile detailed records of findings and communicate audit results to stakeholders, managing expectations effectively
• Implement strategies to identify and prevent fraudulent activities, ensuring compliance with legal and regulatory standards

Required qualifications

• Minimum Bachelor's Degree required
• 0 - 2 years of relevant experience required; 2 - 4 years preferred
• Certified Fraud Examiner or Accredited Healthcare Anti-Fraud Investigator preferred