Aetna® Special Investigation Unit

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Join our team to help lead the fight against fraud

Aetna, a CVS Health Company, is an industry-leading, diversified health solutions company with more than 170+ years of experience providing innovative, quality benefits, products and services to businesses, individuals, employers, health care professionals, producers, the government and others.

Aetna is expanding our Special Investigation Unit  across all lines of business. We have exciting career opportunities for skilled professionals to lead the fight against health care fraud, waste, and abuse as we help ensure our members receive the highest quality care.

Explore available career opportunities below and check back regularly for new postings!
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Career areas

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Coding

In this role, which requires AAPC Coding Certification as a Certified Professional Coder (CPC), you will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers.  

Investigations 

In this role, you will support for complex investigations into suspected and known acts of healthcare fraud, waste, and abuse (FWA).      

Quality

In this role, you will be responsible for completing quality reviews of the work of investigators to ensure compliance with state regulations, effective fraud prevention, and the recovery of lost funds.
A sense of mutual respect and mindfulness permeates our culture-in fact, it’s the key to our success.

Recently, the North Carolina State Health Plan Board of Trustees unanimously selected Aetna to administer health benefits for more than 575,000 individuals who teach, protect, and serve our great state.  

This investment in Aetna’s SIU will foster an expansion of provider-level claim coding reviews, increased investigative capacity, and targeted investigations into specialty areas, such as Dental, to address emerging schemes requiring specialized SIU support.
A sense of mutual respect and mindfulness permeates our culture-in fact, it’s the key to our success.
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Hear what our vice president has to say about the type of talent we’re adding to our team: Leading the fight against fraud.

We’re building a world of health around every consumer, delivering superior care and value with heart. We care for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. We care at our core and we welcome all heart-minded talent to serve our communities.
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PHENOM BENEFIT

Benefits are more than pay, time off and 401k. We believe they should be more holistic – supporting every aspect of your life. See how we can better your life at Phenom Market.
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 “We are adding to our outstanding team of professionals within our Special Investigations Unit (SIU) who support Fraud, Waste & Abuse detection and mitigation. We are looking for candidates who champion quality, inspire trust, and put people first through excellence, integrity, and innovation.”

Jessica Conley
Vice President, Provider Experience, Interoperability, Digital Solutions, and Provider Operations, Aetna
A sense of mutual respect and mindfulness permeates our culture-in fact, it’s the key to our success.

Benefits

Taking care of our customers begins with taking care of our colleagues. We’re proud to offer award-winning benefits to support your overall wellness – physical, emotional and financial – because we know they’re all interconnected. 
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Phenom People offers the opportunity for personal and professional growth on an unprecedented scale. Yo will innovate.
A sense of mutual respect and mindfulness permeates our culture-in fact, it’s the key to our success.

Earn Your High School Diploma

As a company, we’re innovating for the greater good – because healthier happens together®.

Let's redefine
health care together.

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