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The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
The Fraud Investigation Technician 2 is responsible for supporting all fraud and abuse cases under development within the TRICARE East contract. This is an essential role in Program Integrity. The support from this role is critical to case development requirements by the Defense Health Agency. There is a great deal of administrative support involved in gathering evidence and creating audit files. The Fraud Investigation Technician 2 also handles all scanning, mailings, office supplies and equipment support requests. This individual must be articulate in communication and also able to write professional business responses. Program Integrity is a highly engaged team which values initiative, collaboration, accountability and teamwork.
Key Accountabilities -
Scanning developed fraud cases, claims, EOB’s, medical records, authorizations
Manage Lead Requests from the Defense Health Agency
Research provider licenses, contracts, certification files and websites
Order office supplies, assign UPS labels, certified mail requests, work orders for building/equipment maintenance. Manage internal correspondence control numbers. Research claims exposure on potential fraudulent schemes. Request medical records. Print and prepare audit folders
Special projects as assigned by leadership
Our Department of Defense Contract requires U.S. citizenship for this position
Successfully receive approval for government security clearance (eQIP Electronic Questionnaire for Investigation Processing)
High School Diploma or GED
Previous Administrative or related experience
Strong written and oral communication skills
Proficiency in Microsoft Office Programs: Word, PowerPoint, Excel, etc.
Ability to manage multiple or competing priorities and work independently as well as in a team environment
Proactive and well organized
Strong attention to detail
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Experience in healthcare setting
Experience with Access
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Company is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Company continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.
Scheduled Weekly Hours
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