Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Healthcare Fraud Investigator

Centene Corporation

Centene Corporation is seeking an investigator to conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, and medical records to identify misconduct and support case resolution.

Responsibilities include documenting investigations, preparing reports, and collaborating with compliance, legal, and external agencies to support corrective actions, recoveries, and case resolution while ensuring compliance with laws and company standards.

#J-18808-Ljbffr
Vacancy posted 13 hours ago
Similar jobs that could be interesting for youBased on the Remote Healthcare Fraud Investigator in United States vacancy
  •  ...To support the DVA VHA in establishing a Fraud Rapid Response Center, the remote Senior Healthcare Fraud Investigator will lead case development by reviewing analytics-generated leads, preparing decision-ready referral packages, and collaborating with federal investigators... 
    Remote work

    Virtual Vocations Inc

    United States
    5 days ago
  •  ...Integrity Management Services, Inc. is seeking an Investigator to conduct high-level Medicare and Medicaid investigations, develop cases...  ...driven investigations, preparing detailed reports, and maintaining case files, with remote work options in the U.S. #J-18808-Ljbffr
    Remote work

    Integrity Management Services

    United States
    14 hours ago
  •  ...To support the growth of a healthcare analytics firm, the full-time remote Healthcare Fraud Investigator will identify and qualify improper-payment leads, manage a live caseload, and drive cases to closure while collaborating with payer clients and internal teams. Key... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    1 day ago
  •  ...Job Opportunity Council Capital is a healthcare-focused private equity firm based in...  ...analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid...  ...but you will not manage anyone. Strong investigators here come from healthcare payer/vendor... 
    Remote work

    City of Groton

    United States
    3 days ago
  • $105k - $115k

     ...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support the DVA VHA in establishing and operating a high-visibility...  ...annually , depending on experience and qualifications. Remote work arrangement with on-site requirements as needed.... 
    Remote work
    For contractors
    Work at office

    Zachary Piper Solutions

    Eastern, KY
    15 hours ago
  •  ...Healthcare Fwa Investigator Levels (Investigator, Sr. Investigator, etc) will depend on experience and...  ...and prevention of healthcare fraud, waste and abuse (FWA). We are growing...  ...Ability to work independently within a remote team, under minimal supervision Benefits... 
    Remote work

    Integrity Advantage

    United States
    2 days ago
  • A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing...  ...a minimum of 5 years in fraud investigations. This is a remote role with a strong preference for residents of New York.... 
    Remote work

    Centene Corporation

    New York, NY
    4 days ago
  • $79.56k - $115.72k

     ...an exciting place to be within the healthcare industry. As a member of Mass General...  ...Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving...  ...generally 8:30-5:00 PM Eastern Time Remote workspace requirements, including... 
    Remote work
    Full time
    Contract work
    Work at office
    Local area
    Monday to Friday
    Flexible hours
    Shift work

    MGH Institute of Health Professions

    Somerville, MA
    2 days ago
  • $77.1k

     ...Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare...  ...Forgiveness Program (PSLF) Responsibilities The SIU Fraud Investigator is responsible for identifying, investigating, and resolving... 
    Remote work
    Full time
    Part time
    Work at office
    Flexible hours

    Metropolitan Jewish Health System

    United States
    13 hours ago
  • SafeGuard Services, a subsidiary of Peraton, is seeking a Fraud Investigator to perform high-level investigations of medical professional service providers. You will develop cases for future action, coordinate with state and federal partners, and prepare investigative... 
    Remote job

    Peraton

    Brooklyn, NY
    4 days ago
  • UnitedHealth Group is seeking a Coding Consultant to investigate healthcare fraud and abuse, reviewing CPT codes, medical records, and related documentation. The role supports internal and external stakeholders and provides guidance on CPT coding during investigations.... 
    Remote job

    Optum

    New York, NY
    5 days ago
  • Peraton seeks a Fraud Investigator for SafeGuard Services to conduct complex investigations of medical providers and develop actionable cases for law enforcement referrals and overpayment recovery. The role requires strong investigative, communication, and organizational... 
    Remote job

    Peraton

    Herndon, VA
    4 days ago
  • A leading live shopping platform is seeking a Fraud Agent to investigate and develop solutions to mitigate fraud. This role requires identifying fraud patterns proactively and working collaboratively with the team to enhance user experience. Candidates should have experience... 
    Remote work
    Work at office
    Work from home

    Whatnot

    Phoenix, AZ
    4 days ago
  •  ...better today and tomorrow.Section 1: Position SummaryThe Senior Fraud Investigator is a senior individual contributor responsible for leading...  ...of education and relevant experience preferredFor all virtual remote positions, in order to ensure associates can effectively... 
    Remote work
    Full time
    Second job

    Ascensus

    Nashville, TN
    4 days ago
  •  ...Clinical Fraud Investigator II Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and...  ...claims and medical records prior to payment. Researches new healthcare related questions as necessary to aid in investigations.... 
    Temporary work
    Work at office
    Local area
    2 days per week
    1 day per week

    Elevance Health

    Tampa, FL
    1 day ago
  •  ...Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete... 
    Full time
    Work experience placement
    Work at office
    Local area

    CGS Federal (Contact Government Services)

    Boston, MA
    3 days ago
  •  ...Healthcare Fraud InvestigatorCGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Oxford, MS. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently... 
    For contractors
    Interim role
    Local area
    Flexible hours

    Contact Government Services LLC

    Oxford, MS
    3 days ago
  •  ...Conducting comprehensive fraud, waste, and abuse investigations, the full-time SIU Investigator will analyze...  ...stakeholders to support case resolution in a remote setting. Key responsibilities...  ...in Business, Criminal Justice, Healthcare, or a related field, or equivalent... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    4 days ago
  •  ...CareSource is seeking a Special Investigations Unit (SIU) III to lead high-complexity investigations into healthcare fraud, waste and abuse. This role requires strong data analysis, interviewing, and reporting capabilities and will coordinate audits and regulatory communications... 

    CareSource

    New York, NY
    13 hours ago
  •  ...Highmark Inc. seeks an experienced anti-fraud investigator to develop and maintain an enterprise fraud program, deliver training, and file fraud plans and reports. You will conduct investigations into fraud, waste and abuse across providers, members, facilities, pharmacies... 

    Highmark Health

    Baton Rouge, LA
    4 days ago
  •  ...Highmark Inc. is seeking an experienced anti-fraud investigator to develop and maintain an anti-fraud program, conduct investigations, and...  ...requirements. The position requires 3 years in health insurance or healthcare fraud investigations, with preferred advanced certifications... 

    Highmark Health

    Montpelier, VT
    3 days ago
  •  ...Independently leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator...  ...and support corrective actions in a remote work environment. Key...  ...Degree in Business, Criminal Justice, Healthcare Administration, Public Health, or a... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    1 day ago
  • $29.37 - $41.12 per hour

    Fraud Investigator IISalal Credit Union is seeking a Fraud Investigator II to play a vital role in safeguarding our members and organization...  ...shape stronger policies and controls to reduce risk.This is a remote position, offering flexibility to work from home. However, preference... 
    Remote work
    Hourly pay
    Local area
    Work from home

    Salal Credit Union

    Seattle, WA
    4 days ago
  • $40 - $46 per hour

     ...Position Title: Fraud Investigator Location: Glen Allen, VA - Hybrid (Tuesday-Thursday onsite; Monday & Friday remote) Clearance Requirements: None Position Status: 6-Month Contract to Hire Pay Rate: $40-$46+/hr D.O.E. Position Description: Our... 
    Remote work
    Contract work
    For contractors
    Monday to Friday

    Seneca

    Glen Allen, VA
    3 days ago
  • $37.45 - $57.29 per hour

     ...their hire date. Basic Life Support Certification (BLS) for healthcare providers. Preferred Qualifications ~ Bachelor's degree...  ...applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related... 
    Remote work
    Hourly pay
    Full time
    Relocation package
    Shift work
    Night shift

    Intermountain Health

    Brighton, CO
    2 hours ago
  • A financial institution is seeking a Fraud Investigator II to safeguard members from financial crime. This remote position requires strong analytical and investigative skills. Candidates should have over three years of banking experience and two years in fraud or financial... 
    Remote work

    Salal Credit Union

    Seattle, WA
    4 days ago
  • $89.17k - $112.94k

     ...interview process. About the Role: Gusto is seeking a Senior Fraud Investigations Analyst to join our Fraud Investigations team. In this role,...  ..., whether you're working in-office, hybrid, or fully remote, so that you stay closely connected to your team, customers,... 
    Remote work
    Full time
    Work at office
    Local area
    2 days per week
    3 days per week

    Gusto, Inc.

    Denver, CO
    7 hours ago
  •  ...AML/Fraud Analyst x 2 – Contract – Remote – $35.00 - $45/hr. The final salary or hourly wage, as applicable, paid to each candidate/applicant for...  ...REQUIREMENTS • Expertise in financial crime analysis and investigative techniques, including identifying unusual or... 
    Remote work
    Hourly pay
    Contract work
    Local area

    Hays

    Vienna, VA
    4 days ago
  • $25 per hour

     ...Job Type: Contract Workplace Type: Hybrid (50% remote, 50% fieldwork) Compensation: $25/hr plus $.50/mi COMPANY...  ...utilities sector. PLC's core service is outside plant damage investigation, recovery, and prevention. Across the US and parts of Canada,... 
    Remote work
    Contract work
    Part time
    For contractors
    Work experience placement
    Local area

    Phoenix Loss Control Inc

    Monett, MO
    1 day ago
  •  ...This position performs field investigations on disability, life, and other insurance claims. This position conducts investigative interviews...  ..., and applicable policy language. This role is fully remote (within California or Dallas, TX) and requires heavy travel (7... 
    Remote work
    Flexible hours

    Ameritas

    United States
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Healthcare Fraud Investigator. Be the first to apply!