Investigator II

Horizon Blue Cross Blue Shield of New Jersey empowers its members to achieve their best health by driving innovations that improve health care quality, affordability, and member experience. The company is seeking an Investigator II to detect, receive, and review suspected fraud and complete cases for resolution. The role requires analytical and investigative activities related to claims, enrollment, accounting, and other operations. The ideal candidate will have a high school diploma, a minimum of 2 years of claims, customer service, or relevant law enforcement experience, and basic knowledge of health insurance operations. The company offers a comprehensive compensation and benefits package, including a salary range of $63,000 to $84,420, comprehensive health benefits, retirement plans, and tuition reimbursement.

Requirements

• High School Diploma/GED required
• Minimum 2 yrs claims, customer service or relevant law enforcement experience required
• ITS/Blue Card knowledge preferred
• Basic knowledge of health insurance operations required
• Basic knowledge of SIU health insurance operations required
• Excellent verbal and written communication skills required
• Ability to effectively handle confrontational situations required
• Demonstrated ability in MS Office applications, in particular Excel and Access required
• Strong organizational skills required

Benefits

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement