Remote Healthcare Fraud & Waste Investigator
Humana Inc
- Remote job
Humana Inc. is seeking a Fraud and Waste Professional to conduct investigations into fraudulent and abusive practices, coordinate with law enforcement, and assemble evidence for adjudication. The role includes on-site audits of provider records and preparation of complex audit reports. Qualified candidates have at least 3 years in healthcare fraud investigations, strong knowledge of payment methodologies, and excellent organizational and communication skills. #J-18808-Ljbffr Humana Inc
- Humana Inc. is seeking a Fraud and Waste Professional to conduct investigations of fraud and abuse and coordinate with law enforcement. You will assemble evidence... ...investigative reports to support adjudication. Remote work is available with minimal travel. Typical hours...Remote job
- Humana is seeking a Fraud and Waste Professional to investigate fraudulent and abusive healthcare practices. The role involves coordinating with law enforcement, gathering... ...guidelines. The position may include remote work with minimal travel and requires strong analytical...Remote job
- ...position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join... ...solution! Job Description Summary: The Fraud, Waste, and Abuse Investigations Manager handles the operational activities related to Pharmacy...Remote workContract workLocal areaMonday to FridayFlexible hoursNight shiftWeekend work
- ...Investigating allegations of potential healthcare fraud and abuse, the full-time SIU Investigator will conduct claims investigations... ...detailed reports while working remotely from various locations. Key... ...investigations of potential waste, abuse, and fraud in healthcare claims...Remote workFull time
- ...Career Enhancement is seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit. This role... ...investigations into suspected healthcare fraud, waste, and abuse while enabling remote work anywhere in the United States. The ideal candidate...Remote jobWork at office
$46.99k - $112.2k
...for Career Enhancement is looking for an experienced Senior Healthcare Fraud Investigator to join the Special Investigations Unit in the United... ...will manage complex investigations into healthcare fraud, waste, and abuse. Your responsibilities include conducting investigations...Remote jobFull time$65k - $88.6k
...part of our caring community. The Fraud and Waste Professional conducts investigations of allegations of fraudulent and... ...guidance where needed. Work Style Remote/Work at Home (minimal travel,... ...Qualifications At least 3 years of healthcare fraud investigations and/or auditing...Remote workTemporary workWork from homeMonday to Friday- Profile We offer remote work opportunities (AK, AR, AZ, CO, FL,... ...adjudicated DOD background investigation for this position. Veterans,... ...and reporting of suspected fraud, waste and abuse (FWA) cases as defined... ...Veterans Affairs (VA), the Healthcare Finance Administration (HCFA...Remote workContract workFor subcontractorInterim role
- Centene Corporation is looking for a dedicated investigator to monitor healthcare fraud activities. You will utilize your investigation skills to ensure... ...benefits package and a flexible work environment including remote options. #J-18808-Ljbffr Centene CorporationRemote jobFlexible hours
- Centene Management Company LLC is seeking candidates for a position dedicated to investigating allegations of healthcare fraud and abuse within the Kentucky Medicaid Program. The ideal applicant will have a Bachelor's Degree in a related field and a minimum of three years...Remote job
- UnitedHealth Group in Omaha, Nebraska, seeks an investigator to assess fraud and misconduct allegations. You will conduct investigations, analyze data, and ensure compliance with regulations while collaborating with internal and external partners. The ideal candidate has...Remote job
- Navanti Group, LLC is seeking a senior healthcare fraud investigator and OSINT analyst to support a sensitive federal law-enforcement customer. The... ...indicators of fraudulent activity. The position is fully remote, requires an active Top Secret clearance, and demands 5+ years...Remote job
$56.2k - $101k
Centene Management Company LLC is looking for a skilled investigator to focus on potential healthcare fraud and abuse activities. The candidate will analyze claims, conduct investigations, and prepare detailed reports for regulatory agencies. A Bachelor's degree in Business...Remote jobFlexible hours- Centene Management Company LLC is seeking a skilled investigator to handle allegations of healthcare fraud and abuse in New York. In this role, you'll plan, organize, and execute claims investigations, utilizing your expertise in data mining and report creation. The ideal...Remote jobFlexible hours
$60k - $92k
...Levels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ..., investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and looking... ...to work independently within a remote team, under minimal supervision Benefits...Remote workFull time- ...Service Corp. is seeking a dynamic professional to join the Fraud Investigations team, focusing on IL Medicaid. The role includes leading investigators... ...in a hybrid setup with three days in office and two remote days. The ideal candidate has a criminal justice or related...Remote workWork at office
- ...Service Corporation in Chicago seeks a Manager of Special Investigations to lead its Fraud Investigations team, oversee IL Medicaid fraud cases,... ...hybrid-flex with in-office visibility three days a week and remote two days. Relocation and sponsorship are not offered. Excellent...Remote workWork at officeRelocationFlexible hours3 days per week
- KMRG, LLC is seeking an experienced Legal Analyst to support the U.S. Department of Justice with healthcare fraud and opioid-related cases. This full-time role offers competitive pay, benefits, and job stability in a government-facing position. Based in Providence, RI,...Remote jobFull time
- Company: Navanti Group, LLC Location: Remote Employment Type: Part-Time / Consultant... ..., with workload varying based on investigative tasking. The position is anticipated to... ...Overview Navanti Group is seeking a senior healthcare fraud investigator and Open-Source...Remote workPart timeWork at officeMonday to Friday10 hours per week
- ...sponsorship. Responsibilities Responsible for fraud and abuse detection activities for the... ...be responsible for day‑to‑day Provider investigation-related inquiries. Utilizes prescription... ...agencies. Cooperates with fraud, waste and abuse efforts with external business...Contract workLocal areaMonday to FridayNight shiftWeekend work
$85k - $105k
...Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in... ...for litigation Analyze data for evidence of fraud, waste and abuse Review and evaluate referrals to determine the need...Full timeWork experience placementSummer workInternshipWork at officeLocal area- ...educational institution in Massachusetts is seeking a Fraud Investigator II to combat fraud, waste, and abuse within the Medicaid program. The ideal... ...competitive salary, and comprehensive benefits including healthcare and retirement plans. #J-18808-Ljbffr University of...Full time
$21.82 - $42.55 per hour
Molina Healthcare is looking for a skilled individual to provide investigative support for the special investigation unit (SIU) focused on medical provider coding fraud, waste, and abuse. The suitable candidate will need to independently evaluate medical claims and maintain...Hourly pay- ...an exciting place to be within the healthcare industry. As a member of Mass General... ...at identifying potential fraudulent, wasteful, or abusive claim submissions. In... ...FunctionsResponsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving...Contract workWork at officeLocal areaFlexible hours
$46.99k - $122.4k
...Alliance for Career Enhancement is hiring for a position focused on investigating healthcare fraud cases. The ideal candidate will have a Bachelor’s degree and at least 3 years of experience in fraud, waste, and abuse investigations. Responsibilities include handling...Full time- CVS Health is seeking a Special Investigations Unit (SIU) Investigator to conduct investigations into healthcare fraud, waste and abuse, and to support recovery of funds while ensuring compliance with federal and state regulations. The role requires 1-3 years of investigative...
$21.82 - $42.55 per hour
Molina Healthcare is seeking candidates for a role focused on investigating medical provider coding fraud, waste, and abuse (FWA). The position requires independent assessment of medical claims, adherence to regulatory standards, and effective communication within teams...Hourly pay- ...and refine analytic reporting aimed at identifying fraudulent, wasteful, or abusive claim submissions. The role includes preliminary... ...reports. The ideal candidate will have 5-7 years of FWA investigation experience, strong data analysis skills, and the ability to translate...
- ...Corporation is hiring for a Fraud Prevention Analyst. In this... ...operations. You’ll combine investigation, analytics, and risk management... ...our Middleton, WI office or remotely from Wisconsin, Arizona,... ...services, benefits administration, healthcare, or another regulated...Remote workWork at officeFlexible hours
- * Responsible for fraud and abuse detection activities for the TennCare... ...for day-to-day Provider investigation-related inquiries.* Utilizes... ...allegations of fraud, waste and abuse involving providers... ...benefits management, #J-18808-Ljbffr MedImpact Healthcare Systems, Inc.Contract workLocal area
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