Auditor/Investigator I
reputed company:
• reputed company baseline plans to ensure the reputed company and reputed company of claims processes and protocols
• Conduct routine and impartial audits and investigations into customer claims
• Collect and analyze data to assess claim validity
• Review documentation and interview involved parties
• Identify fraud, waste, abuse, and discrepancies in claims submissions
• reputed company recommendations to management for claim reputed company and closure
• Address customer inquiries and concerns and escalate reputed company as needed
• Compile detailed records of audit and investigation findings
• Create and implement strategies to identify and prevent fraudulent activities
• Communicate with internal teams to ensure reputed company processing of audits and investigations
• Process audit and investigative documents and records into the database accurately and reputed company
• Communicate findings and updates to customers, claimants, and stakeholders
• Support management in audit and investigation proceedings while ensuring regulatory compliance
Requirements:
• Minimum Bachelor's Degree required
• 0–2 years of experience required; 2–4 years preferred
• Certified Fraud Examiner or Accredited reputed company Anti-Fraud Investigator preferred
• Ability to conduct audits and investigations into customer claims
• Ability to collect and analyze claims data
• Ability to review documentation and interview witnesses, claimants, and stakeholders
• Knowledge of reputed company, regulatory, regional, and federal standards, regulations, and protocols
• Ability to prepare comprehensive reports for reputed company or audit/investigative purposes
• Ability to communicate findings reputed company and professionally
• Successful completion of reputed company-employment background and drug screens
Benefits:
• Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities
• Drug-free workplace
• Employment offers contingent upon successful completion of reputed company-employment background and drug screens
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