[Remote] Fraud and Waste Investigator at Humana

A Bachelor's degree or equivalent work experience is required, along with strong clinical experience in multiple practice areas, at least 2 years of healthcare fraud investigations and auditing experience, knowledge of healthcare payment methodologies, strong organizational, interpersonal, and communication skills, an inquisitive nature with data analysis ability, computer literacy in MS Word, Excel, and Access, and strong personal and professional ethics.

The role supports work from home with specific internet requirements: at minimum a download speed of 25 Mbps and upload speed of 10 Mbps is recommended, using wired cable or DSL; satellite, cellular, or microwave connections only if approved by leadership. Humana provides telephone equipment, and associates in California, Illinois, Montana, or South Dakota receive bi-weekly internet expense payments.

This information is not specified in the job description.

The role involves becoming part of a caring community focused on putting health first, contributing to an organization passionate about continuously improving consumer experiences, and understanding department and organizational strategy.

Strong candidates will have a graduate degree or certifications like MBA, J.D., MSN, CPC, CCS, CFE, or AHFI, understanding of the healthcare industry, claims processing, investigative processes, and experience in a corporate environment with business operations knowledge.