Fraud and Waste Investigator
HumanaFull Time
Junior (1 to 2 years)
United States
Candidates should possess a Bachelor's degree in Law Enforcement, Criminal Justice, Liberal Arts, Business, Computer Science, or a related discipline, or equivalent experience. A minimum of 3 to 6 years of related experience, including criminal investigation or fraud detection, is required. Professional designations such as Certified Fraud Examiner or a Private Investigator license are preferred.
The Special Claims Desk Investigator will conduct investigations into suspect fraud referrals, gather necessary documentation, and identify trends in fraudulent activity. They will manage field investigations, coordinate with law enforcement and other agencies, and prepare detailed investigation reports. The role involves evaluating claims, recommending actions, and potentially testifying in court. Additionally, the investigator will perform database searches, prepare reports using investigative technology, and may assist in developing fraud awareness programs or training.