Anticipated End Date:2026-10-20Position Title:Investigator AssistantJob Description:Investigator Assistant
Location: Hybrid 1 - This role requires associates to be in-office 1 - 2 days per week , fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Work Shift: Monday - Friday, 7:00 am to 5:00 pm (flexible with starting time and ending time for a daily 8 hours work shift)
The Investigator Assistant is responsible for providing administrative support to the pharmacy investigative unit and performing research on data to assist in identifying cases of potential overpayment or abuse.
How you will make an impact: Collects, researches, and validates bills and claims data against relevant guidelines.
Assists in preparation of statistical and financial analysis reports.
Responds to state and law enforcement requests for information.
Requests medical records and additional documentation required for investigation.
Completes initial file set-up and tracks cases.
Works with vendors in providing case status and updates.
Processes and tracks all incoming reimbursement checks.
Assists in managing fraud hotline calls.
Provides administrative support for investigative management and staff.
Minimum Requirements:



Requires a HS diploma or equivalent and minimum of 1 year experience in healthcare, retail pharmacy and/or Medicaid; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences: One year or more of MS Excel experience working with large data files and other general reporting tools preferred.
Experience in Health insurance, law enforcement highly preferred .
Pharmacy technician license and/or pharmacy experience preferred.
Formulary, clinical rules, pharmacy claims analysis, and/or prior authorization experience for a pharmacy benefit manager or health plan strongly preferred.
Ability to communicate information clearly and concisely, both orally and in writing in a professional and legal environment strongly preferred.
For candidates working in person or virtually in the below locations, the pay* range for this specific position is $19.38/hr. to $33.43/hr.
Location(s): California, Virginia
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company.



The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
*The salary range is the range Elevance Health in valuable faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, and—
Job Level: Non-Management Non-Exempt
Workshift: 1st Shift (United States of America)
Job Family: FRD > Investigation
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work At Elevance Health, we are creating a culture that is de

#J-18808-Ljbffr

📌 Investigator Assistant (British Columbia)
🏢 Elevance Health (Anthem)
📍 British Columbia