Back to all jobs

Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home

Work from home Full-time role Hiring

The job profile for this position is Fraud Senior Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. 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. 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
  • 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. 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. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Apply To This Job

Related remote jobs

[Remote] Community Voice & Content Reviewer

Work from home Full-time role

Freelance Brand Writer (Freelance) (Tester)

Work from home Full-time role

Medical Reviewer LPN 26-13483

Work from home Full-time role

Alpha Telescopii – Entertainment Media Content Reviewer (Remote in the United States) – Remote

Work from home Full-time role

Virtual App Reviewer (WFH / Immediate Start)

Work from home Full-time role

Search Engine Evaluator – Flexible Time

Work from home Full-time role

CRM Operations Evaluator - Fully Remote | Upto $120/hr

Work from home Full-time role

Online Content Evaluator – Flexible Working Hours

Work from home Full-time role

Search Engine Evaluator – Flexible Time

Work from home Full-time role

Audio Evaluator - Fully Remote | Upto $50/hr Hourly

Work from home Full-time role

LN Venues, Staff Accountant II

Work from home Full-time role

Director of Regional Field Sales - Central

Work from home Full-time role

Experienced Healthcare Customer Service Representative - Remote Position | Virtual Call Center Support for Medical Clients

Work from home Full-time role

Hernia Sales Specialist (Little Rock AR/Memphis TN)

Work from home Full-time role

Experienced Customer Service Representative - Sales (Hybrid) – Connect with arenaflex Customers and Drive Sales Growth

Work from home Full-time role

Remote Night Shift Customer Service Representative

Work from home Full-time role

Project Manager for manufacturing OT (hybrid/remote)

Work from home Full-time role

Seasonal

Work from home Full-time role

AI & HPC Infrastructure Engineer

Work from home Full-time role

Steuerfachkraft (m/w/d) in Lehrte mindestens 52.000€ - 100% Remote möglich

Work from home Full-time role