System One is Hiring an Associate Health Insurance Investigator Near Baltimore, MD
ALTA IT is hiring an Associate Investigator to support a leading health insurance customer. The individual will work with the Special Investigations Unit (SIU) to assist in the reduction and recuperation of losses. You will research and analyze data using company anti-fraud software, Excel, and other tools to proactively identify new potential cases.
Pay: $32/HR Location: Fairfax, VA (Hybrid) twice a week
Job Duties:
Research provider/subscriber claims activity, operations manuals, data systems, medical policies, job duties and group benefit contracts to identify control deficiencies and non-compliance.
Conduct preliminary research to gather evidence for the investigators.
Determine if an individual's information is different than the information provided.
Mail out letters to individuals to obtain information to determine if they're fraudulent.
Prepare documentation needed to determine if an individual has committed fraud for the investigators.