New Jersey Licensed Investigator II
A company is looking for an Investigator II to conduct analytical and investigative activities related to fraud detection and resolution. Key Responsibilities Detects fraudulent activities by various parties including subscribers and providers Decides on the most effective investigation methods for individual cases Prepares and documents fraud cases, including evidence assembly for potential prosecution Required Qualifications, Training, and Education Bachelor's Degree required Minimum of 2 years of claims, customer service, or relevant law enforcement experience required AHFI, CFE, or CPC certifications preferred In-depth knowledge of health insurance operations required Working knowledge of NJ Criminal and Civil Law relative to health insurance fraud preferred
A company is looking for an Investigator II to conduct analytical and investigative activities related to fraud detection and resolution.
Key Responsibilities
Detects fraudulent activities by various parties including subscribers and providers
Decides on the most effective investigation methods for individual cases
Prepares and documents fraud cases, including evidence assembly for potential prosecution
Required Qualifications, Training, and Education
Bachelor's Degree required
Minimum of 2 years of claims, customer service, or relevant law enforcement experience required
AHFI, CFE, or CPC certifications preferred
In-depth knowledge of health insurance operations required
Working knowledge of NJ Criminal and Civil Law relative to health insurance fraud preferred
