Investigator III
Premera Blue Cross(24 days ago)
About this role
The Investigator III on Premera’s Special Investigations Unit leads complex external fraud, waste, and abuse investigations within a not-for-profit health insurance organization. The role is focused on protecting members and recovering improper payments while ensuring compliance with company policies and applicable laws. As a senior position, it contributes to cross-organizational collaboration with internal teams and external agencies and supports prevention and policy efforts.
Required Skills
- Fraud Investigation
- Data Analysis
- Surveillance
- Interviewing
- Case Management
- Technical Writing
- Claims Analysis
- Data Mining
- Excel
- Access
+3 more
Qualifications
- Bachelor's Degree (Business Administration, Health Care Administration, Finance, Accounting, Nursing, Criminal Justice)
- Certified Professional Coder (CPC)
- Certified Fraud Examiner (CFE)
- Accredited Health Care Fraud Investigator (AHFI)
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