Investigator, Special Investigations Unit (Aetna SIU)
6 days ago
Oklahoma City
We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time. The Special Investigations Unit (SIU) Investigator conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with federal and state regulations mandating fraud plans and practices. • 1-3 years of investigative experience in the area of healthcare fraud, waste and abuse., • Experience with Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research., • Ability to travel for business purposes and legal proceedings, • Certified Professional Coder (CPC), AHFI, CFE, • Bilingual English/Spanish, • Dental investigative experience, • Dental clinical experience, • Knowledge of CDT and ADA, • Commercial/Medicare experience, • Strong communication and customer service skills and the ability to effectively interact with Aetna's customers., • Exercises independent judgment and uses available resources and technology to develop evidence in support of case investigations., • Bachelor's Degree in Criminal Justice, Healthcare Management, Public Health, Biological Sciences, Data Analytics, or other related field preferred or equivalent experience. Anticipated Weekly Hours: 40 Time Type: Full time Pay Range: $43,888.00 - $93,574.00 Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full?time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well?being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.