Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home

The Cigna Group

3d • Remote

About The Position

The job profile for this position is Fraud Senior Analyst, which is a Band 3 Senior Contributor Career Track Role.
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Bilingual Spanish Junior Healthcare Fraud Investigator:
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.
This is a fantastic opportunity for someone with a Bachelors degree in Criminal Justice and is early in their career seeking to grow in a dynamic organization.
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.

Requirements

• 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
• 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.

Responsibilities

• 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 This Job Offers

• Job Type: Full-time
• Career Level: Entry Level