Investigations Specialist

Modivcare is looking for an Investigations Specialist to receive, research and report on allegations of potential or actual fraud, waste, and abuse (FWA).You will monitor use and billing trends that may indicate FWA. You will use resources, including communications with members, facilities, clients, law enforcement, and other parties, to investigate potential or actual FWA. You will report to our Compliance leadership team.

• Advise management team on issues relating to FWA investigations processes
• Process faxes, mail, email, and web requests related to allegations or patterns indicating potential or actual FWA
• Report to management team bona fide allegations of potential or actual FWA
• Assist management team with reports to and regular/ad hoc status calls with clients or law enforcement regarding allegations or patterns indicating potential or actual FWA
• Work with Network Services personnel to fulfill internal, client, or law enforcement requests for field investigations involving allegations or patterns indicating potential or actual FWA
• Provide outreach and education to members, facilities, clients, law enforcement, and company personnel regarding FWA

• High School Graduate or General Education Degree / Graduate Equivalency Degree (GED)
• 3+ years' contact center or front office medical facility experience

• 3 Medical Plans with Prescription Drug Benefits
• 2 Dental Plans
• Vision Benefits
• Employer Paid Basic Life Insurance and AD&D
• Voluntary Life Insurance (Employee/Spouse/Child)
• Health Care and Dependent Care Flexible Spending Accounts
• Pre-Tax and Post --Tax Commuter and Parking Benefits
• 401(k) Retirement Savings Plan with Company Match
• Paid Time Off
• Paid Parental Leave
• Short-Term and Long-Term Disability
• Legal Services
• Critical Illness, Accident, Hospital Indemnity and Cancer Insurance
• Tuition Reimbursement
• Relocation Services
• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

5 brands have joined together for one calling and we recognized an important need--to improve access to care by addressing the social factors that influence patient health outcomes. Our roots as a logistics leader have laid the foundation for our transformation into a tech-enabled healthcare company making better connections to care.

Modivcare requires all employees to be vaccinated for COVID-19. Modivcare is an equal opportunity employer and consistent with federal, state, and local requirements, will consider requests for exemptions from this policy as required under the law.

Salary: $19.17 - $25.56 / Hourly

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.