Fraud and Waste Investigator Position Available In East Baton Rouge, Louisiana
Tallo's Job Summary: The Fraud and Waste Investigator at Humana's Louisiana Medicaid line of business conducts investigations into fraudulent and abusive practices. Responsibilities include collaborating with law enforcement, assembling evidence, conducting on-site audits, and preparing reports. Ideal candidates are self-starters, organized, skilled in interviews, and able to collaborate effectively. This role offers remote/work at home options with minimal travel.
Job Description
Become a part of our caring community and help us put health first
The Fraud and Waste Investigator conducts investigations into allegations of fraudulent and abusive practices within Humana’s Louisiana Medicaid line of business. The Fraud and Waste Investigator’s work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Fraud and Waste Investigator collaborates investigations with law enforcement authorities. The Fraud and Waste Investigator assembles evidence and documentation to support successful adjudication, where appropriate. The Fraud and Waste Investigator conducts on-site audits of provider records ensuring appropriateness of billing practices. The Fraud and Waste Investigator prepares investigative and audit reports. The Fraud and Waste Investigator must exercise good judgment with considerable latitude in determining objectives and approaches to assignments.
To thrive in this role, the following attributes and experience would be helpful: Self-starter and organized
Interview skills and able to conduct a thorough investigation to maintain compliance with Humana and governmental requirements
Able to collaborate with internal and external partners (Law Enforcement, Legal, Compliance). Use your skills to make an impact
WORK STYLE
Remote/Work At Home (minimal travel,
