Investigator Assistant supports the Payment Integrity line of business. This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. Carelon Payment Integrity, part of Elevance Health, aims to recover, eliminate and prevent unnecessary medical-expense spending. The Investigator Assistant provides administrative support to the investigative unit and performs research on data to assist in identifying cases of potential overpayment or abuse. Responsibilities include collecting, researching, and validating bills and claims data against relevant guidelines; assisting in preparation of statistical and financial analysis reports; requesting medical records and additional documentation required for investigation; completing initial file set-up and tracking cases; processing and tracking all incoming reimbursement checks; assisting in managing fraud hotline calls; and providing administrative support for investigative management and staff. Minimum requirements include a high school diploma or equivalent and at least 1 year of experience or an equivalent combination of education and experience. The position is non-management, non-exempt, and part of the FRD > Investigation job family. Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contributions, subject to eligibility. The company is committed to equal pay opportunities and equal employment opportunity without discrimination. Elevance Health operates a hybrid workforce strategy requiring onsite presence at least once per week unless specified otherwise.
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