Financial Investigator III

Responsibilities: Performs in-depth investigative activities relating to alleged fraudulent claims. When requested by management and/or subpoenaed by law enforcement, gathers documentation to support investigative efforts. Compiles and investigates information gathered from various internal and external sources to determine financial exposure to potential fraud activities. Builds and maintains case files for presentation to management and presents recommendations for further action. Searches claims and provider systems to identify claims trends and tracks activities that may be potential fraud issues. Prepares trend reports for management. Provides assistance to senior investigative staff and management on complex cases and collaborates with counsel on special projects. May testify on behalf of Independence as required. Conducts interviews of subjects and third parties.

Qualifications: Undergraduate degree in criminal justice or related field preferred. Minimum of 5 years' experience with financial, criminal, or law enforcement investigations. In lieu of a degree, must have 8-10 years' experience in specialized law enforcement. Must understand technical and financial aspects of the health insurance industry. Strong writing, communication, and computer skills required. Independence has implemented a Hybrid model which consists of associates working in the office three days a week (Tuesday, Wednesday, and Thursday) and remotely two days a week (Monday and Friday). This role is designated as a role that fits into the Hybrid model. While associates may work remotely on designated remote days, the work must be performed within the Tri-State Area of Delaware, New Jersey, or Pennsylvania. IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. Must have an Android or iOS device that is compatible with the free Microsoft Authenticator app. Inclusion and Belonging At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. About Our Company Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day. At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you! IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.