Job Description

Abacus Corporation is a family-owned staffing leader with 80+ years of experience, providing modern workforce solutions nationwide. With a supportive culture and over 25,000 employees, we offer long-term jobs, competitive pay, benefits, and real growth opportunities.

Overview:

Abacus Solutions Group is seeking detail-oriented and analytical Investigators/Claims Reviewers for an immediate contract role based in Newark. This position plays a critical role in ensuring the integrity, accuracy, and compliance of claims submitted. The ideal candidate will have strong investigative skills, a commitment to public service, and the ability to interpret complex regulations and policies.

Key Responsibilities:

• Review and evaluate claims for eligibility, accuracy, and compliance with state and federal regulations
• Conduct investigations into potentially fraudulent, misrepresented, or disputed claims
• Gather and analyze evidence including documentation, interviews, and data records
• Prepare detailed reports summarizing findings, conclusions, and recommended actions
• Collaborate with legal, audit, and enforcement teams as needed
• Communicate with claimants, providers, and other stakeholders to clarify information or resolve discrepancies
• Maintain accurate and confidential case files and documentation

Qualifications:

• 2+ years of experience in investigations, claims review, auditing, or regulatory compliance
• Experience working in a state or government agency is a plus
• Experience with Salesforce is preferred
• Knowledge of state and federal laws governing claims processing and fraud prevention
• Strong analytical, organizational, and communication skills
• Proficiency in Microsoft Office and case management systems
• Ability to work independently and manage multiple cases simultaneously
• High ethical standards and commitment to confidentiality

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