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Highmark Health

Senior Investigations & Fraud Lead

Career Insights for Claims Investigator

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Based on Maryland data

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What they do

A Claims Investigator investigates and assesses insurance claims to verify the validity of insurance claims. Determines the level of liability and determines pay-out amounts. Prepares evaluation reports to document the evidence to be used in court.

$69,535 / year median in Maryland

+1% projected growth

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Job Description

Job Summary Highmark Health is seeking a senior investigator within Enterprise Incident Management to coordinate enterprise-wide responses to large-scale incidents and conduct internal investigations related to employee misconduct, fraud, privacy and security breaches. The role requires strong collaboration with risk partners and audit teams to ensure investigations adhere to standards and are well-documented.

The candidate will apply fraud investigative tools, perform risk assessments, and support#J-18808-Ljbffr Job Description Highmark Health is seeking a senior investigator within Enterprise Incident Management to coordinate enterprise-wide responses to large-scale incidents and conduct internal investigations related to employee misconduct, fraud, privacy and security breaches. The role requires strong collaboration with risk partners and audit teams to ensure investigations adhere to standards and are well-documented.

The candidate will apply fraud investigative tools, perform risk assessments, and support#J-18808-Ljbffr