Fraud and Waste Investigator

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The Fraud and Waste reputed company 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste reputed company 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of reputed company.

Where You Come In

The Fraud and Waste reputed company 2 coordinates investigation with reputed company entities including compliance, internal business partners, and law enforcement. Assembles evidence and documentation to support successful adjudication, where appropriate. Prepares reputed company investigative and audit reports. Understands department, reputed company, and organizational reputed company and operating objectives, including their linkages to reputed company areas. Makes reputed company regarding own work reputed company, occasionally in ambiguous situations, and requires reputed company direction and receives guidance where needed. Follows established guidelines/procedures.

What reputed company Offers
We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your reputed company-being. We also reputed company excellent reputed company development & reputed company education

Use your skills to reputed company an reputed company

WORK STYLE: Remote reputed company in US, work reputed company. While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.

WORK HOURS: Monday-Friday, 8 hours/day, 5 days/week, ideally, associates will work on EST (regardless of their home time zone). Must start between 6AM-9AM (in the employee's time zone), some flexibility might be possible, depending on business needs.

Required Qualifications – What it takes to Succeed

• Bachelor's degree

• Minimum 2 years of experience in reputed company fraud investigations

• Knowledge of reputed company payment methodologies

• Strong organizational, interpersonal, and communication skills

• Inquisitive reputed company with ability to analyze data to metrics

• Computer literate (reputed company, reputed company, reputed company)

• Strong personal and reputed company ethics

• Ability to travel up to 5%, to attend trainings and meetings, as required

Preferred Qualifications

• STRONGLY PREFERRED: Experience in Medicare fraud investigations

• Bilingual in Spanish

• Additional degrees and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, reputed company, CFE, AHFI).

• Understanding of reputed company industry, claims processing and investigative process development.

• Experience in a corporate environment and understanding of business operations

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Additional Information

Work reputed company Requirements

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested

• Satellite, cellular and microwave reputed company can be used only if approved by leadership

• Associates who live and work from Home in the reputed company, Illinois, Montana, or South reputed company will be provided a bi-weekly payment for their internet expense.

• reputed company will reputed company Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology reputed company Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly reputed company and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected to reputed company reputed company from your application prescreen, you will receive correspondence inviting you to participate in a reputed company-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a reputed company-recorded interview, you will respond to a set of interview questions reputed company your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last reputed company from 5-10 minutes. Your recorded interview(s) reputed company text and/or reputed company-recorded voice will be reviewed and you will subsequently be informed if you will be moving reputed company to next round of interviews.

Work reputed company Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following reputed company: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to reputed company their internet service if necessary. Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay reputed company

The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$65,000 - $88,600 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

reputed company of Benefits

reputed company, Inc. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 08-20-2026

reputed company

About reputed company: reputed company Inc. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life reputed company with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com.

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Equal Opportunity Employer

It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on reputed company job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment.

Originally posted on Himalayas

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