The Complex Investigative Review Specialist (CIRS) is a key member of the health and dental team that delivers robust and effective health and dental claims fraud prevention to Great-West Life customers. The main function of the Complex Investigative Review Specialist is to conduct investigations by assessing case information and analytical aspects of the data and then contact providers and clinics to validate services to ensure that claims are free from suspicion of fraud/abuse. The CIRS works closely with their leader in determining investigative next steps as well as other members of the teams including data analysts and members of Special Investigations.
Taking into consideration the evidence and other information gathered the CIRS will propose and execute recommendations regarding resolution, referral to Special Investigations or recovery. The CIRS is responsible for ensuring that case documentation is accurate and complete and will write case reports as needed for Special Investigations, senior leadership and clients.
Qualifications and Competencies:
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Great-West Life offers competitive compensation, great benefits such as medical, dental, life insurance, wellness account and personal days not to mention onsite cafeteria and fitness facilities. If you’d like to join our team submit your information online and introduce yourself.
Together Great-West Life, London Life and Canada Life serve the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations.
We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential.
Great-West Lifeco would like to thank all applicants, however only those who qualify for an interview will be contacted.