Investigator (Fraud Specialist)
Location: Hartford Connecticut
Description: Cigna is in need of Investigator (Fraud Specialist) right now, this occupation will be placed in Connecticut. For detail informations about this occupation opportunity please give attention to these descriptions. Job Description
Performs specified investigative steps related to investigation of known or suspected fraud perpetrated against the company or customers. Utilizing independent judgment and discretion, plans and initiates the appropriate course of action for the purpose of resolution and restitution of high dollar amounts. Determines and acquires information pertinent to and ! impacting each situation investigated. Prepares reports to expedite tracking and reporting of investigations. Prepares evidence packages for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies. Interfaces and coordinates investigations with appropriate State and Federal law enforcement agencies. Responds to subpoenas and requests for information from law enforcement agencies and State Departments of Insurance. May represent company as a witness in judicial proceedings when appropriate. Performs special projects requiring expertise in fraud detection, investigation, claim auditing and other areas related to Special Investigations. Handles more general, mid-sized cases. Works independently receiving direction and guidance.
Responsibilities
Through interviews, analysis, and investigation, resolves allegations or suspicions of fraud against our customers and company. Must comply with reporting requir! ements, subpoenas, and requests for investigative assistance, ! while, at the same time, protecting our customers PHI. This position requires significant contact with other business areas and outside agencies, such as Law Enforcement, Attorneys, and Departments of Insurance.
Qualifications
5+ years related experience is strongly preferred
Related experience in insurance investigations and/or claims processing required
Computer skills are essential
Strong communication skills, both written and oral, are essential
Must be able to adapt to changing priorities .
- .
If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Cigna.
If you interested on this occupation just click on the Apply button, you will be redirected to the official website
This occupation starts available on: Tue, 25 Feb 2014 18:43:30 GMT