About this role
The job profile for this position is Fraud Lead Analyst, which is a Band 3 Senior Contributor Career Track Role.
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
The Fraud Investigator leads in-depth investigations into suspected or confirmed fraud impacting our customers or the company. Using strong judgment and independence, this role identifies the right investigative approach, gathers and analyzes critical information, and drives cases toward resolution and potential restitution.
You’ll prepare clear investigative reports, build evidence packages for external partners, and collaborate closely with state and federal agencies. You may also respond to subpoenas and represent the company in legal proceedings. This role requires protecting customer PHI while managing sensitive, high‑value cases.
Key Responsibilities:
Conduct interviews, research, and analysis to resolve fraud allegations.
Manage complex, high-dollar investigations with minimal supervision.
Prepare detailed reports and evidence packages for insurance fraud bureaus, contract holders, and law enforcement.
Coordinate investigations with local, state, and federal agencies.
Respond to subpoenas and regulatory requests; provide testimony when needed.
Support special projects involving fraud detection, auditing, and investigative best practices.
Partner with internal departments while maintaining strict confidentiality standards.
Requirements:
Bachelor’s degree in Criminal Justice or related field or 7+ years of investigative claims experience.
3+ years of health insurance investigation or audit experience strongly preferred.
Strong computer and analytical skills; proficiency in Microsoft Excel, Access, and Word preferred.
Excellent written and verbal communication skills.
Ability to adapt quickly to changing priorities and work independently.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Other facts
About The Cigna Group
The Cigna Group is a global health company committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health.
The Cigna Group includes products and services marketed under Cigna Healthcare, Evernorth Health Services or its subsidiaries. The Cigna Group maintains sales capabilities in more than 30 countries and jurisdictions, and has more than 190 million customer relationships around the world.
What you'll do
- The Fraud Investigator leads investigations into suspected or confirmed fraud, preparing reports and evidence packages while collaborating with various agencies. This role requires managing sensitive cases and protecting customer PHI.
Ready to join The Cigna Group?
Take the next step in your career journey