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Senior Investigator
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$73,360 - $126,546 a year
Full-time
- Location: This position will work a hybrid model (remote and office).
- 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.
- Claim reviews for appropriate coding, data mining, entity review, interviewing, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims.
- Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one company health plan, line of business and/or state.
- May interface internally with Senior level management and legal department throughout investigative process.
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