Job Summary
A health insurance company is searching for a person to fill their position for a Remote Investigator.
Core Responsibilities Include:
- Using appropriate system tools and databases for analysis of data and review of professional and facility claims to detect fraudulent, abusive or wasteful healthcare insurance payments to providers and subscribers
- Preparation of statistical/financial analyses and reports to document findings and maintain up-to-date electronic case files for management review
- Receiving offers of settlement for review and discussion with management
Must meet the following requirements for consideration:
- Requires a BA/BS and minimum of 2 years related experience
- Excellent verbal and written communication skill
- Positive attitude to work
