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Investigator – Claims Audit, Investigation Services
Alberta Blue CrossClaims Auditor conducting health audits and investigations at Alberta Blue Cross. Collaborating with providers for compliance and reporting findings in a hybrid work environment.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting health audits and investigations, with a strong focus on compliance analysis and effective communication. Proven ability to build relationships with service providers and internal partners while addressing client needs.
Highest-signal resume keywords
Health AuditsInvestigative Designation (CFI or CFE)Claims AnalysisMicrosoft ExcelInvestigation Interviewing
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Health AuditsClaims AnalysisInvestigationsData AnalysisReport Preparation
Soft Skills
Exceptional Communication SkillsRelationship Building
Tools & Technologies
DatabasesMicrosoft Excel
Certifications & Qualifications
CFICFE
Industry Keywords
ComplianceDocumentation CollectionProcess ImprovementPolicy Recommendations
About the role
Key responsibilities & impact- Conduct health audits and investigations
- Travel within Alberta for documentation collection
- Complete claims analysis for compliance
- Prepare working papers, letters, and reports
- Issue reports on claims and monetary adjustments
- Develop and maintain relationships with service providers and internal partners
- Address client needs and recommend changes to processes and policies
Requirements
What you’ll need- Post-secondary education in science, business, criminal justice, healthcare, or law
- Investigative designation such as CFI or CFE preferable
- 3-5+ years experience in investigations
- Exceptional communication skills
- Experienced in investigation interviewing
- Knowledge of databases and ability to analyze large amounts of data using Microsoft Excel
- Ability to establish and maintain effective working relationships with both internal and external customers
Benefits
Comp & perks- Health coverage for over 1.8 million members
- Opportunities for career growth
- Healthy work-life balance