Health Insurance Investigator (Open to hiring at the Sr. level)

Health Insurance Investigator (Open to hiring at the Sr. level)

• Full-time
• Department : Legal | Compliance | Audit | Risk
• Pay Grade : 19

Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on 85 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you're passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!

Reporting to the Team Leader of SIU & Compliance, you will identify and investigate suspected provider and member health insurance fraud, waste and abuse, identify potential losses and recoveries for the corporation, prepare reports of suspected fraud, waste and abuse, and work with law enforcement agencies and anti-fraud organizations, as appropriate. Investigations must be conducted in accordance with company policies and procedures and in compliance with all applicable laws and regulations.

Required :

Preferred :

Key Responsibilities :

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com

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