Investigator, Special Investigations Unit (Aetna SIU)
CVS Health
•$43,888 - $93,574•Onsite
About The Position
The Special Investigations Unit (SIU) Investigator conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with federal and state regulations mandating fraud plans and practices.
Requirements
- 1-3 years of investigative experience in the area of healthcare fraud, waste and abuse.
- Experience with Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research.
- Ability to travel for business purposes and legal proceedings.
Nice To Haves
- Certified Professional Coder (CPC), AHFI, CFE
- Bilingual English/Spanish
- Dental investigative experience
- Dental clinical experience
- Knowledge of CDT and ADA
- Commercial/Medicare experience
- Strong communication and customer service skills and the ability to effectively interact with Aetna's customers.
Responsibilities
- Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse.
- Recovers lost funds.
- Complies with federal and state regulations mandating fraud plans and practices.
- Exercises independent judgment and uses available resources and technology to develop evidence in support of case investigations.
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
