Lead/Senior Fraud Investigator

Summary

Highmark Inc. is seeking an experienced investigator to develop and maintain an anti-fraud program, including training, fraud plans, and annual reporting.The role conducts investigations of provider, member, and facility fraud, waste, and abuse, with interviews that may be onsite or offsite. It coordinates data extracts from multiple databases, supports law enforcement, and ensures compliance with internal audits and regulatory requirements.#J-18808-Ljbffr

Job Description

Highmark Inc. is seeking an experienced investigator to develop and maintain an anti-fraud program, including training, fraud plans, and annual reporting.The role conducts investigations of provider, member, and facility fraud, waste, and abuse, with interviews that may be onsite or offsite. It coordinates data extracts from multiple databases, supports law enforcement, and ensures compliance with internal audits and regulatory requirements.#J-18808-Ljbffr