2 yrs required
Jacksonville, FL, United States
Fraud and Waste Investigator
The candidate assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Manage a large caseload of pharmacy fraud investigations while making decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
10690 Beach Blvd
United States 32246
Website : http://www.humana.com
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