Are you ready to launch your Healthcare Fraud Investigator career and make a real difference? If you're a recent college graduate eager to take the first step in your professional journey, this early‑career opportunity is designed for you.
As a Junior Fraud Investigator for Cigna's Special Investigations Unit, you’ll support our US Commercial Healthcare Business in conducting and supporting audits and investigations of potentially fraudulent claim activity by providers. You will bring investigative and analytics skills that include planning, developing and implementing investigative processes and procedures, along with making recommendations for potential corrective actions that include prosecution, recovery and/or litigation based on investigative findings.
What you’ll do:
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
What you need to do the job:
- Bilingual Spanish and ability to pass oral and written assessments
- Diploma or Criminal Justice experience, 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
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
