Senior Investigator
Highmark Health(19 days ago)
About this role
Highmark Inc. is seeking a professional responsible for developing and maintaining an anti-fraud program, conducting investigations into healthcare fraud, waste, and abuse, and working with law enforcement agencies. The role involves field investigations, training, and compliance with regulatory requirements. It requires coordination across various teams to identify and prevent fraud activities.
Required Skills
- investigations
- Data Mining
- Claims Processing
- Fraud Detection
- Regulatory Compliance
- Healthcare Billing
- Risk Management
- Analysis
- Court Testimony
- Audit
Qualifications
- Bachelor's Degree in related field
- 5 years in healthcare fraud investigations
About Highmark Health
highmarkhealth.orgA national health and wellness organization as well as the second largest integrated delivery and financing system in America.
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