Investigations Support Specialist - Fraud & Compliance

Independence Blue Cross; Philadelphia (Philadelphia County); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Independence Blue Cross in Philadelphia is seeking an Investigative Support Specialist to provide administrative and operational support to the Corporate and Financial Investigations Department. You will coordinate intake, maintain case records, track allegations, and support recovery efforts while ensuring compliance with regulatory requirements.

The role requires attention to detail, strong organizational skills, and discretion handling confidential information.

Qualifications

• High school diploma or equivalent required.
• 2+ years in administrative support, healthcare operations, compliance, fraud prevention, investigations support, records management, or related field.
• Strong organizational and time-management skills; ability to manage multiple priorities.

Responsibilities

• Receive and process allegations of Fraud, Waste, and Abuse from multiple channels.
• Acknowledge receipt and request additional information when needed.
• Create, maintain, and update case records for tracking and reporting.
• Review and organize case materials for investigative review.
• Assign cases to team members per procedures.
• Maintain electronic and physical investigative files per policies.
• Coordinate record retention activities and compliance with standards.
• Process refunds and restitution payments; maintain recovery records.
• Support preparation of departmental reports and regulatory documentation.
• Collaborate with internal and external stakeholders while maintaining confidentiality.

Skills

Organizational skills

Time management

Attention to detail

Written communication

Verbal communication

Teamwork

Independence

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

Independence Blue Cross in Philadelphia is seeking an Investigative Support Specialist to provide administrative and operational support to the Corporate and Financial Investigations Department. You will coordinate intake, maintain case records, track allegations, and support recovery efforts while ensuring compliance with regulatory requirements.

The role requires attention to detail, strong organizational skills, and discretion handling confidential information.