Note: The job is a remote job and is open to candidates in USA. Cigna Healthcare is dedicated to improving the health and vitality of those they serve. They are seeking a Healthcare Investigator to lead in-depth investigations into suspected or confirmed fraud impacting customers or the company, utilizing strong judgment and independence to drive cases toward resolution.
Responsibilities
• Conduct interviews, research, and analysis to resolve fraud allegations
• Manage complex, high-dollar investigations with minimal supervision
• Prepare detailed reports and evidence packages for insurance fraud bureaus, contract holders, and law enforcement
• Coordinate investigations with local, state, and federal agencies
• Respond to subpoenas and regulatory requests; provide testimony when needed
• Support special projects involving fraud detection, auditing, and investigative best practices
• Partner with internal departments while maintaining strict confidentiality standards
Skills
• Bachelor's degree in Criminal Justice or related field or 7+ years of investigative claims experience
• Excellent written and verbal communication skills
• Ability to adapt quickly to changing priorities and work independently
• 3+ years of health insurance investigation or audit experience strongly preferred
• Strong computer and analytical skills; proficiency in Microsoft Excel, Access, and Word preferred
Benefits
• Medical
• Vision
• Dental
• Well-being and behavioral health programs
• 401(k)
• Company paid life insurance
• Tuition reimbursement
• A minimum of 18 days of paid time off per year
• Paid holidays
Company Overview
• We are a health benefits provider that advocates for better health through every stage of life. It was founded in 1982, and is headquartered in Bloomfield, CT, US, with a workforce of 10001+ employees. Its website is http://www.cigna.com.
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