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Bilingual Junior Healthcare Fraud Investigator
The Cigna GroupJunior Fraud Investigator conducting audits and investigations for Cigna's healthcare business. Analyzing claims activities and preparing reports for potentially fraudulent activities in Florida.
About the role
Key responsibilities & impact- 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
What you’ll need- Bilingual Spanish and ability to pass oral and written assessments
- 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
Comp & perks- Health insurance
- Flexible work arrangements
- Professional development opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
analytical skillsinvestigationauditreport writingevidence preparationsubpoena responseconflict managementreasoning skills
Soft Skills
bilingual Spanishverbal communicationwritten communicationleadershipability to deal with ambiguity