Investigator II
BlueCross BlueShield of Tennessee · Nashville, TN · 2 mo ago
Information TechnologyFull-time
Job Responsibilities
- Preparing legal and investigation documentation
- Presenting findings and making recommendations to management
- Participating in legal proceedings when necessary
- Analyzing all evidence, looking for possible fraud, and conducting ongoing investigations
- Conducting interviews with parties involved and obtaining the information needed to determine the validity of claims
Job Qualifications
- Education: Bachelor's Degree or equivalent work experience required
- Experience: 8 years - Experience in the investigation of healthcare fraud investigations or similar white collar criminal investigations required
Skills & Certifications
- Industry designation involving Healthcare Fraud Investigation, such as the Certified Fraud Examiner (CFE), Accredited Health Care Fraud Investigator (AHFI), Associate, Life and Health Claims (ALHC), Certified Insurance Fraud Investigator (CIFI)
Company Information
BlueCross BlueShield of Tennessee fosters a culture of innovation, including responsible use of AI-enabled tools to enhance how we serve our members.