Remote Healthcare Fraud & Waste Investigator
Humana
Humana Inc. is seeking a Fraud and Waste Professional 2 to coordinate investigations of fraudulent and abusive practices across internal and external entities, assemble evidence, and prepare complex investigative and audit reports in support of adjudication. This is a remote opportunity in the United States with occasional travel to Humana offices for training or meetings. Typical hours are 40 per week with a start between 6 AM and 9 AM in the employee's time zone. #J-18808-Ljbffr
$65k - $88.6k
...part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and... ...We are fortunate to offer a remote opportunity for this job. Our Fortune... ...2 years of experience in healthcare fraud investigations Knowledge of...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$65k - $88.6k
...Humana is looking for an experienced Healthcare Investigator to join its industry leading Special... ...do you have a passion for combating Fraud, Waste, and Abuse in the Health Care Industry... ...information. Travel: While this is a remote position, occasional travel to Humana...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome office$65k - $88.6k
...part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and... ...We are fortunate to offer a remote opportunity for this job. Our Fortune... ...2 years of experience in healthcare fraud investigations Knowledge...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims data, collaborate with internal teams, and prepare comprehensive reports for compliance and...Remote workFull time
- ...Leading complex fraud investigations in healthcare billing, coding, and claims, the full-time remote Senior Fraud Investigator will analyze large data sets to identify patterns... ...large data sets to detect potential fraud, waste, and abuse in healthcare billing and claims...Remote workFull time
- ...Healthcare Fwa Investigator Levels (Investigator, Sr. Investigator, etc) will depend on experience... ...investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and... ...to work independently within a remote team, under minimal supervision...Remote work
$85k - $105k
...Healthcare Fraud InvestigatorCGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. The candidate must... ...litigation.Analyze data for evidence of fraud, waste and abuse.Review and evaluate referrals to determine...Remote workWork experience placementWork at officeLocal area- ...Centene Corporation seeks an Investigator to conduct fraud, waste, and abuse investigations across healthcare programs. You will review referrals, claims data, and medical records, document findings, and support case resolution while ensuring regulatory and contractual...Remote work
- ...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,... ...you will not manage anyone. Strong investigators here come from healthcare payer/vendor...Remote work
$85k - $105k
...Healthcare Fraud InvestigatorEmployment 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... ...data for evidence of fraud, waste and abuse.Review and evaluate...Remote workFull timeWork experience placementWork at officeLocal area$79.56k - $115.72k
...exciting place to be within the healthcare industry. As a member of... ...potential fraudulent, wasteful, or abusive claim submissions... ...conducting confidential investigations of suspected fraud, waste & abuse (FWA)... ...0-5:00 PM Eastern Time Remote workspace requirements, including...Remote workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work- ...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
- ...The University of Massachusetts Medical School seeks a Fraud Investigator II in Healthcare to combat fraud and abuse within the Medicaid program. This... ...in Microsoft Office are essential. The position is remote, allowing for flexible work arrangements. #J-18808-LjbffrRemote workWork at officeFlexible hours
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and provider abuse using CPT coding guidance. You will mentor investigators, review claims against medical records, and coordinate with internal and external stakeholders to ensure...Remote job
$79.56k - $115.72k
...exciting place to be within the healthcare industry. As a member of... ...potential fraudulent, wasteful, or abusive claim submissions... ...conducting confidential investigations of suspected fraud, waste & abuse (FWA)... ...0-5:00 PM Eastern Time Remote workspace requirements, including...Remote workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work$76.6k - $127.6k
...As a Project - Consultant, Forensics and Investigations on the project, you will address the threats that perpetuate fraud, waste, and abuse, our clients look to our team to... ...investigations and referrals of suspected healthcare fraud for potential action. Utilize specialized...Local area- ...Medica is seeking an experienced SIU Investigator IV to lead complex fraud, waste, and abuse investigations involving members, providers, and employees. The role also covers onsite audits, collaboration with legal and law enforcement, and guiding investigative processes...Work at office
- ...Fraud Investigator IIUnder the general direction of the Associate Director, or designee, the Fraud... ...a crucial role in combating fraud, waste and abuse (FWA) within the Medicaid program... ...of federal and state regulations and healthcare industry standards.Conduct independent...Work at office
- ...Conducting comprehensive fraud, waste, and abuse (FWA) investigations, the full-time SIU Investigator will analyze... ...compliance with regulations in a remote work environment. Key responsibilities... ...in Business, Criminal Justice, Healthcare Administration, Public Health, or...Remote workFull time
- ...Job Description Job Description Fraud Analyst / Financial Crimes Fraud Investigator Location - Remote and Onsite Thrice a week - Winchester, VA // Pensacola,... ...Our expertise spans industries from providing healthcare information systems to developing E-Remit software...Remote workHourly payWorldwide
$66k - $106k
...subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent... ...reduce, and make referrals to recover fraud, waste, and abuse. What you'll do:... ...of investigative practices regarding healthcare providers. Knowledge of Medicare...Remote workContract workFor contractorsFlexible hoursShift workNight shift- Medica in Minnetonka, MN is seeking an SIU Investigator III to lead complex investigations into fraud, waste, and abuse involving members, providers, and employees. You will work with legal teams and regulatory agencies, perform on-site audits, analyze evidence, and prepare...Work at office
- Medica is seeking an SIU Investigator III to join our Minnetonka, MN office. This onsite role conducts complex fraud, waste and abuse investigations, performs onsite audits and provider reviews, and collaborates with Legal, Regulatory, and law enforcement partners to advance...Work at office
$53.25k - $88.75k
...Plan is currently hiring a Senior Fraud and Abuse Investigator/CPC/CFI/CFS/CHC/CFE/AHFI - Remote! Status: Full-time, permanent... ...Coder (CPC) or Certified in Healthcare Compliance (CHC) Certified... ...assessments, data mining, fraud, waste and abuse (FWA) analysis, and proactive...Remote workPermanent employmentFull timeTemporary workCurrently hiringWork at officeShift work- Medica in Minnetonka, MN is seeking an SIU Investigator IV to lead advanced fraud, waste, and abuse investigations involving members, providers, and employees. You will manage complex cases, review evidence from multiple sources, and guide actions that support legal or...
- ...processes, collecting data for audits and investigations, interviewing stakeholders, and... ...applying regulatory knowledge to identify fraud, waste, and abuse, with opportunities to... ...across teams. A Bachelor's degree and healthcare fraud experience are preferred. #J-18...Full time
- ...Job Description Job Description Description: Claims Investigator - Desktop Remote Immediate need for a Claims Investigator - Desktop within... ...needed. Investigators must be familiar with insurance fraud, common fraud schemes, and various ways to report fraud at...Remote workFull timeLocal areaImmediate startWorldwide
- ...corporate office with remote work flexibilityTravel... ...to 25%The Compliance Investigator is responsible for conducting... ...safety, privacy, and healthcare operations across one... ...coding concernsFraud, waste, and abuse risksHIPAA... ...(CHPC)Certified Fraud Examiner (CFE)Comparable...Remote workWork at office
$40.76 per hour
...Healthcare Fraud InvestigatorMacon, GAOnsiteAre you a detail-oriented legal professional who enjoys investigative work, analyzing complex information, and helping attorneys build successful cases? We're seeking an experienced Investigator with legal experience to play...Hourly payFull timeContract workWork at office- ...Healthcare Fraud Investigator Employment Type: Full-Time, Experienced Department: Litigation Support CGS 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...Full timeFor contractorsInterim roleLocal areaFlexible hours
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