Healthcare Fraud Investigator - Work from home at Cigna in Bloomfield, Connecticut

Job Description:

Join our Special Investigations Unit as a Fraud Investigator, supporting our US Commercial Healthcare Business, r esponsible for conducting and supporting audits and investigations of potentially fraudulent claim activity by providers. You will bring complex investigative and analytic skills that include planning, developing and implementing investigative processes and procedures. You will make recommendations for potential corrective actions that include prosecution, recovery and/or litigation based on investigative findings.

Key Responsibilities:

• Analyze information gathered by investigation/audit and report findings and prepare written summary/recommendations


• Prepare evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies


• Lead on-site inspections and patient/provider interviews as necessary


• Respond 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


• Perform special projects requiring expertise in fraud detection, investigation, claim auditing and other areas related to Special Investigations


• Prepare reports to expedite tracking and reporting of investigations

Minimum Requirements:

• Minimum 3 years' experience in health insurance investigation/audit


• Bachelor's Degree in Criminal Justice or related field strongly preferred


• Clear and concise verbal and written communication skills


• Strong computer skills are required - Excel, Access and Word


• Accredited Health Care Fraud Investigator (AHFI) certification and Certified Fraud Examiner (CFE) preferred

For this position, we anticipate offering an annual salary of $62,800 - $104,600, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we'll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and best in class well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the "Life at Cigna" tab on our careersite: www.cigna.com/careers

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.