Job summary
Job post source
This job is directly from Elevance Health
Job overview
The Investigator I at Elevance Health supports the Payment Integrity line by investigating claims to detect fraud, abuse, or wasteful practices, contributing to reducing unnecessary medical expenses.
Responsibilities and impact
The role involves investigating cases, analyzing claim data using system tools, preparing reports, maintaining case files, reviewing settlement offers with management, and communicating findings to internal and external customers.
Experience and skills
Requires a BA/BS and at least 2 years of related experience in healthcare insurance, law enforcement, or equivalent education and experience.
Work environment and culture
The position offers a hybrid work model with 1-2 days in-office per week to balance collaboration and productivity, supporting work-life balance.
Company information
Elevance Health includes Carelon Payment Integrity, focused on recovering and preventing unnecessary medical spending.
Job location and travel
The job is hybrid based in New York, requiring 1-2 days per week in the office.
Company overview
Elevance Health, formerly known as Anthem, Inc., is a leading health benefits company in the United States that provides a diverse range of medical, pharmaceutical, dental, behavioral health, and other related services. They generate revenue primarily through premiums from their health insurance plans, administrative fees for managing self-funded plans, and government contracts for Medicare and Medicaid services. An important historical note is their rebranding from Anthem to Elevance Health in 2022, reflecting their broader commitment to elevating whole health and advancing health beyond healthcare.
How to land this job
Tailor your resume to emphasize investigative skills, experience with claim data analysis, and familiarity with healthcare insurance or law enforcement environments as these are central to the Investigator I role at Elevance Health.
Highlight your ability to use system tools and databases for data analysis, your experience preparing detailed reports, and your communication skills for internal and external stakeholders.
Apply through multiple platforms including Elevance Health’s corporate careers page, LinkedIn, and job boards where the position is listed to maximize your application’s reach.
Connect on LinkedIn with current employees in the Payment Integrity division at Elevance Health; use ice breakers like commenting on recent company initiatives related to fraud prevention or expressing curiosity about their experience working hybrid in New York.
Optimize your resume for ATS by incorporating keywords from the job description such as 'investigating cases,' 'claim data analysis,' 'fraud detection,' 'payment integrity,' and 'healthcare insurance' to ensure it passes automated screenings.
Use Jennie Johnson's Power Apply feature to automate tailoring your resume, identify the best application channels, and find relevant LinkedIn contacts, freeing up your time to focus on preparing for interviews and networking effectively.
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