Investigator – Claims Audit, Investigation Services

Posted 2 weeks ago

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About the role

  • Claims Auditor conducting health audits and investigations at Alberta Blue Cross. Collaborating with providers for compliance and reporting findings in a hybrid work environment.

Responsibilities

  • Conduct health audits and investigations
  • Travel within Alberta for documentation collection
  • Complete claims analysis for compliance
  • Prepare working papers, letters, and reports
  • Issue reports on claims and monetary adjustments
  • Develop and maintain relationships with service providers and internal partners
  • Address client needs and recommend changes to processes and policies

Requirements

  • Post-secondary education in science, business, criminal justice, healthcare, or law
  • Investigative designation such as CFI or CFE preferable
  • 3-5+ years experience in investigations
  • Exceptional communication skills
  • Experienced in investigation interviewing
  • Knowledge of databases and ability to analyze large amounts of data using Microsoft Excel
  • Ability to establish and maintain effective working relationships with both internal and external customers

Benefits

  • Health coverage for over 1.8 million members
  • Opportunities for career growth
  • Healthy work-life balance

Job title

Job type

Full Time

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

HybridEdmontonCanada

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