Remote Healthcare Fraud Investigator
Centene Corporation
Centene Corporation is seeking an investigator to conduct fraud, waste, and abuse investigations across referrals, claims data, and medical records. You will document findings, prepare reports, and coordinate with internal and external stakeholders to support program integrity and regulatory compliance.
The role requires a Bachelor's degree and 2+ years in healthcare investigations, with opportunities to work in a remote, hybrid, or onsite setting and benefit from Centene's comprehensive package.
#J-18808-Ljbffr- ...Peraton’s SafeGuard Services (SGS) is seeking a Fraud Investigator to conduct complex investigations into medical professional services, develop cases for potential referrals, and coordinate with law enforcement and other agencies. The role requires independent judgment...Remote work
- ...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 work
$65k - $88.6k
...our caring community The Fraud and Waste Professional is responsible... ...conducting comprehensive investigations of reported, alleged or... ...Responsibilities Analyze healthcare payment methodologies,... ...Waste Work Style Fully remote in the contiguous US, with occasional...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ...investigation and prevention of healthcare fraud, waste and abuse (FWA). We are... ...to work independently within a remote team, under minimal...Remote work
$115k
...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support a mission focused on protecting Veterans and taxpayer dollars... ...rapid-response oversight initiatives. This position is remote and candidates must be local to Washington, DC . The Senior...Remote workFor contractorsLocal area- ...Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention, detection, and investigation... ...healthcare fraud, waste, and abuse, while working remotely. Key responsibilities Conducts...Remote workFull time
- ...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
- ...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...Remote work
- ...Humana Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations and coordinate with law enforcement to protect the Medicaid program. This fully remote role supports nationwide program integrity efforts and requires strong analytical and communication...Remote work
$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 workFor contractorsWork at office- ...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
- ...Humana Inc. seeks a Fraud and Waste Professional to conduct comprehensive investigations of reported or suspected fraud within Medicaid... .... The position is fully remote in the contiguous US, with... ...Bachelor's degree and 2+ years in healthcare fraud investigations, plus...Remote work
$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 workFull timePart timeWork at officeFlexible hours$105k - $115k
...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support a Government Consulting company supporting the Department of... ...of Integrity and Compliance (OIC). This position is 100% remote and focused on healthcare fraud lead development, case analysis...Remote workWork at officeLocal area$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 workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work- Elevance Health is seeking an Investigator II to identify and develop healthcare fraud cases, recover funds, and work with law enforcement. The role emphasizes data-driven reviews of claims, coding accuracy, and collaborative investigations across programs. The ideal candidate...Remote job
$56.2k - $101k
...in Florida are highly preferred. Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing,... ...plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay...Remote jobFull timePart timeWork at officeFlexible hours$24 - $30 per hour
Job Type Full-time Description Claims Investigator - Desktop Remote Immediate need for a Claims Investigator - Desktop within the largest worldwide... ...needed. Investigators must be familiar with insurance fraud, common fraud schemes, and various ways to report fraud at...Remote workFull timeLocal areaImmediate startWorldwide- ...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 timeWork experience placementWork at officeLocal area
- ...Highmark Inc. seeks a senior anti-fraud investigator to develop and maintain an enterprise fraud program, deliver training, and file annual fraud plans and reports. The role conducts interviews with providers, members, and others, coordinates data extracts, and may testify...
- ...Highmark Inc. is seeking an experienced anti-fraud professional to develop and maintain an comprehensive fraud program and conduct investigations into fraud, waste and abuse across providers, members, facilities and employees. The role requires testimony in court and...
- ...A healthcare organization is looking for a Special Investigations Unit Investigator II to investigate fraud and abuse in the healthcare environment. This role conducts thorough investigations leveraging data analytics, ensuring compliance with regulations, and supports...
- ...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 contractorsInterim roleLocal areaFlexible hours
- ...Clinical Fraud Investigator II Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity... ...claims and medical records prior to payment. Researches new healthcare related questions as necessary to aid in investigations....Temporary workWork at officeLocal area2 days per week1 day per week
- ...Highmark Inc. is seeking a seasoned anti-fraud investigator to develop and maintain the organization’s fraud program, conduct investigations into potential fraud, and coordinate with law enforcement. This role may involve onsite interviews and fieldwork, with a focus...
- ...CVS Health is seeking a Senior Investigator in Ohio to conduct high‑level investigations of healthcare fraud and abuse, including Medicaid matters, handling sensitive, national cases and providing testimony when required. Requirements: 4+ years in healthcare fraud investigations...
- ...CareSource is seeking a Senior Investigator in Arkansas to lead high-complexity fraud investigations in healthcare. You will research data, identify patterns, and develop action plans with cross-functional teams. The role requires expert knowledge of Medicaid/Medicare...
- ...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...
- ...Description This position is remote; however, you must be located near a Huntington Corporate Office or branch building as you... ...be required to go into office on occasion. Summary The Fraud Investigator role within the Fraud Investigations Departments at Huntington...Remote workFull timeH1bWork at officeLocal areaWork from homeFlexible hours
- ...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 workFull timeSecond job
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