Investigator I (US)

Investigator I Locations: Columbus, OH or Cincinnati, OH. Hybrid 1 Arrangement 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. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless granted an accommodation as required by law. Responsibilities Use appropriate system tools and databases for analysis of data and review of professional and facility claims to detect fraudulent, abusive or wasteful healthcare insurance payments to providers and subscribers. Prepare statistical/financial analyses and reports to document findings and maintain up-to-date electronic case files for management review. Prepare final case reports and notification of findings letters to providers. Receive offers of settlement for review and discussion with management. Use strong communication skills, both oral and written, for contact with all customers, internal and external, regarding findings. Minimum Requirements BA/BS degree and minimum of 2 years related experience preferably in healthcare insurance departments such as Grievance and Appeals, Contracting or Claim Operations, law enforcement; or any combination of education and experience that provides an equivalent background. Preferred Skills & Experience Healthcare experience is strongly preferred. Prior insurance company experience is preferred. Salary Range For candidates working in person or virtually in Columbus, OH, the salary range for this position is $61,200 to $91,800. Benefits Comprehensive benefits package. Incentive and recognition programs. Equity stock purchase plan. 401(k) contribution. Medical, dental, vision, short- and long-term disability, life insurance and wellness programs. Paid holidays and paid time off. Hybrid Work Arrangement Elevance Health operates 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. Vaccination Requirement All new candidates in certain patient/member-facing roles must be vaccinated against COVID-19 and Influenza. If not vaccinated, the offer will be rescinded unless an acceptable explanation is provided. Equal Employment Opportunity 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 View email address on click.appcast.io 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. #J-18808-Ljbffr Elevance Health