Investigations Analyst

Highmark Health is looking for an experienced Investigations Analyst with the necessary skills and knowledge to join our team. As an Investigations Analyst, you will be responsible for researching and assessing potential fraud, waste, and abuse in our healthcare system. Our ideal candidate must have excellent investigative skills, be well-versed in healthcare regulations, have strong communication skills, and be able to think critically. If you have the dedication and drive to help us continue our mission of providing quality healthcare, then apply today!

Responsibilities:

1. Research and assess potential fraud, waste, and abuse in the healthcare system.
2. Utilize investigative skills and knowledge of healthcare regulations to identify any suspicious activity.
3. Collaborate with various departments to ensure compliance with healthcare regulations.
4. Develop and analyze reports to uncover any suspicious activity or discrepancies.
5. Maintain a detailed log of all investigations and records.
6. Communicate effectively with stakeholders to ensure a positive outcome.
7. Develop and implement strategies to prevent future fraud, waste, and abuse.
8. Stay up to date on all healthcare-related laws and regulations.
9. Respond to inquiries from internal and external stakeholders regarding investigations.
10. Provide guidance and support to other members of the Investigations team.

According to JobzMall, the average salary range for a Investigations Analyst in Jefferson Hills, PA, USA is between $61,000 and $80,000 per year. This range is dependent on experience, qualifications, and the specific job role.

Highmark Inc. is among the largest health insurers in the United States and the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.2 million members. Its diversified health businesses serve group customer and individual health needs across the United States through dental insurance, vision care and other related health businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.