Junior Healthcare Fraud Investigator - Bilingual, Work From Home, FL

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.

Candidate delivers upon specific delegated tasks assigned by a supervisor in the Audit job family. Performs specified investigative steps related to investigation of known or suspected fraud perpetrated against the company or customers. Contributes to special projects requiring expertise in fraud detection, investigation, claim auditing and other areas related to Special Investigations. Primary focus is to mitigate the risk of fraud in the South Florida region. Completes day-to-day anti-fraud investigation tasks with limited supervision. Tasks involve a degree of heightened sense of urgency, applied learnings and proactive anticipation of needs/issues.

This is a fantastic opportunity for someone with a Bachelor’s degree in Criminal Justice and is early in their career seeking to grow in a dynamic organization.

What you’ll do:

• Analyze evidence gathered and prepare written summary/recommendations

• Prepare evidence package for referral to Fraud Investigators

• Support on-site inspections and activity checks

• Perform patient and provider interviews

• Oversee various projects related to the handling of an Investigation

What you need to do the job:

• Bilingual in English and Spanish required

• A bachelor’s degree in a Criminal Justice, or related field (Economic Crime)

• 0-2 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

This role is WAH, which allows most work to be performed at home. Must be located in South Florida in close vicinity to the Sunrise, FL office.

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.

For this position, we anticipate offering an annual salary of 52,500 - 87,500 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

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.