Job Description

Investigator Assistant

Investigator Assistant

Location: Hybrid 1 - This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Work Shift: Monday Friday, 8 am to 5 pm (EST)

The Investigator Assistant is 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 will you 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.

Minimum Requirements:

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

Preferred Skills, Capabilities and Experiences:

• Strong experience with Microsoft Word and Excel.
• Knowledge of CPT codes and medical terminology highly preferred.

Job Level: Non-Management Non-Exempt

Workshift: 1st Shift (United States of America)

Job Family: FRD > Investigation

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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