Elevance Health-posted 3 days ago
Full-time • Entry Level
Hybrid • Wallingford, CT
5,001-10,000 employees

Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Title: Investigator Assistant Location: Wallingford, CT Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Investigator Assistant is responsible for providing administrative support to the investigative unit and performing research on data to assist in identifying cases of potential overpayment or abuse.

  • Collects, researches, and validates bills and claims data against relevant guidelines.
  • Assists in preparation of statistical and financial analysis reports.
  • Requests medical records and additional documentation required for investigation.
  • Completes initial file set-up and tracks cases.
  • Processes and tracks all incoming reimbursement checks.
  • Assists in managing fraud hotline calls.
  • Provides administrative support for investigative management and staff.
  • Requires a HS diploma or equivalent and minimum of 1 year experience; or any combination of education and experience, which would provide an equivalent background.
  • Strong experience with Microsoft Word and Excel.
  • Knowledge of CPT codes and medical terminology is highly preferred.
  • We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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