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SalarySupports the Payment Integrity line of business
Location: This position will work a hybrid 1 schedule with 1-2 days in office per week. The ideal candidate will live within 50 miles of our Atlanta, GA location.
Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.
The Investigator Assistant is responsible for providing administrative support to the investigative unit and performing research on data to assist in identifying cases of potential overpayment or abuse.
How you will make an impact:
- Collects, researches, and validates bills and claims data against relevant guidelines.
- Assists in preparation of statistical and financial analysis reports. Requests medical records and additional documentation required for investigation.
- Completes initial file set-up and tracks cases.
- Processes and tracks all incoming reimbursement checks. Assists in managing fraud hotline calls.
- Provides administrative support for investigative management and staff.
Minimum Requirements
- Requires a HS diploma or equivalent and minimum of 1 year experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications
- Experience using Excel is preferred.
- Experience using Microsoft Word is preferred.
- Medical coding/ billing experience preferred.
- Investigative background (law enforcement, private investigations) is preferred.
- Knowledge of internal department systems preferred.
