Claims Fraud Investigator

About Pacific Blue Cross

Pacific Blue Cross (PBC) has been British Columbia’s leading benefits provider for over 80 years. It is an independent, not‑for‑profit society rooted in BC’s health care system, providing health, dental, life, disability and travel coverage to 1 in 3 British Columbians through employee group plans and individual plans.

Perks

• Flexible working hours : 7.5 hours per day, Monday to Friday (37.5 hours per week).
• Paid vacation : starts at 4 weeks per year and increases with service.
• Hybrid work environment : combination of office and home days.
• Generous health, dental and life insurance benefits; premiums can be 100% paid by PBC depending on the plan chosen.
• PBC contributes the equivalent of 8% of your base salary to a Defined Contribution pension plan, with no employee contribution or matching required.
• Onsite gym, cafeteria, and 24 / 7 virtual doctors / counsellors via the Employee Family Assistance Program.

About The Position

We are searching for a permanent Claims Fraud Investigator to join our Fraud Investigations team. The role involves investigating member and provider dental and extended health claims, identifying fraudulent activity, and pursuing recovery of ineligible funds.

The typical hiring range is $68,000‑$82,000 per year, with a base salary based on skills, education and experience. Eligible candidates will receive an annual bonus and the full benefits package described above.

This position works hybrid from home and our head office in Burnaby, BC. Apply this week to take on this important role.

Key Ways This Position Makes An Impact

As a Claims Fraud Investigator, you will profile member and provider dental and extended health claims, conduct comprehensive investigations of suspected fraud and insurance abuse, and pursue recovery of ineligible funds.

You will analyze cases, develop investigative plans, gather evidentiary material, and prepare comprehensive reports with evidence findings and recommended recovery actions.

Additionally, you will prepare file documentation for regulatory bodies and / or law enforcement.

Key Experiences You Bring To This Role

Preferred : knowledge of the Health Professions Act.

To apply, visit www.pbchbs.com / company / careers / and submit your application this week.

Diversity, Equity, and Inclusion

PBC is an Indigenous Works employer of choice, an award winner for diversity, equity, and inclusion, a Greenest employer, and a Pride at Work partner. We strive to create a workplace where everyone feels valued and employees can freely participate regardless of race, ethnicity, gender, sexual orientation, religion, ability, education level, parental status or socioeconomic status. We are an equal‑opportunity employer and welcome applications from all qualified candidates.

To request accommodations in the application process, email careers@pac.bluecross.ca. Accommodation requests will be reviewed confidentially on a case‑by‑case basis by Human Resources.

Referrals increase your chances of interviewing at Pacific Blue Cross by 2x.

Location : Burnaby, British Columbia, Canada.

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