Job Description

Investigator Assistant

Responsible for providing administrative support to the investigative unit and performing research on data to assist in identifying cases of potential overpayment or abuse.

How You Will Make an Impact:

• Collects, researches, and validates bills and claims data against relevant guidelines
• Assists in preparation of statistical and financial analysis reports
• Requests medical records and additional documentation required for investigation
• Completes initial file set-up and tracks cases
• Processes and tracks all incoming reimbursement checks
• Assists in managing fraud hotline calls
• Provides administrative support for investigative management and staff

Required Qualifications:

• Requires a HS diploma or equivalent and minimum of 1 year experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Healthcare experience is strongly preferred
• Strong Excel Experience strongly preferred
• Knowledge of Healthcare, coding, billing procedures strongly preferred

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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