Remote Prepay Coding & Fraud Investigator
Optum
- Remote job
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. The position offers telecommuting within the United States, requires CPC/CCS/RHIT/RHIA credentials and several years of CPT coding experience, with a focus on accuracy and regulatory compliance. #J-18808-Ljbffr Optum
$77.1k
...Forgiveness Program (PSLF) Responsibilities The SIU Fraud Investigator is responsible for identifying, investigating, and resolving... ...matters Certified Professional Coder preferred Certified Coding Specialist preferred Certified Fraud Examiner preferred...Remote workFull timePart timeWork at officeFlexible hours- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud, audit CPT coding, and provide guidance to investigators. The role supports internal and external projects, mentoring colleagues, and ensuring regulatory compliance. The position...Remote job
- 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 workWork at officeWork from home
$78k
...Fraud Investigator II Minimum Salary US-MA-Westborough Job Location 1 month ago(8/19/2026 3:29 PM) Requisition Number 2026-51896 # of Openings 1 Posted Date Day Shift Exempt Union Code Non Union Position - Non Unit Professional (W60) Position Type Full-Time Min USD $7...SuggestedFull timeWork at officeShift work- ...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
- ...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
$51.07k - $66.44k
...Division: MFCU Section: Medicaid Fraud Control Unit (MFCU) Opening Date: 09... ...Attorney General. Description Investigators are assigned cases under the direction of... ...of health care operations, billing, coding and documentation guidelines is preferred...Full timeWork at officeNight shift- ...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
- ...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 workFull time
- ...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... ...of Medicaid/Medicare rules, CPT/HCPCS/ICD coding, and evidence-based methods to drive case...
- ...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-LjbffrRemote work
- ...Conducting comprehensive fraud, waste, and abuse investigations, the full-time SIU Investigator will analyze claims data, medical records, and provider... ...collaborating with stakeholders to support case resolution in a remote setting. Key responsibilities Conducts investigations...Remote workFull time
- ...integrity platform pairs analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid, Commercial, and... ...and customer success, but you will not manage anyone. Strong investigators here come from healthcare payer/vendor backgrounds or from investigative...Remote work
- ...Independently leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator will utilize advanced investigative techniques... ...identify misconduct and support corrective actions in a remote work environment. Key responsibilities Conducts...Remote workFull time
$105k - $115k
...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support the DVA VHA in establishing and operating a high-visibility... ...0 annually , depending on experience and qualifications. Remote work arrangement with on-site requirements as needed....Remote workFor contractorsWork at office$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 workHourly payLocal areaWork from home- 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
- ...Healthcare Fwa Investigator Levels (Investigator, Sr. Investigator,... ...and prevention of healthcare fraud, waste and abuse (FWA). We are... ...ICD, CPT, HCPCS, DRG, and rev codes Ability to demonstrate... ...work independently within a remote team, under minimal supervision...Remote work
$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 workContract workFor contractorsMonday to Friday$79.56k - $115.72k
...Functions: Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving medical providers, plan members... ...Friday schedule, generally 8:30-5:00 PM Eastern Time Remote workspace requirements, including privacy and security...Remote workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work- 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
$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 workFull timeWork at officeLocal area2 days per week3 days per week- ...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 workHourly payContract workLocal area
$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 workContract workPart timeFor contractorsWork experience placementLocal area- ...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 workFlexible hours
$135k - $185k
...billions in annual payment volume.As a Senior Fraud Analyst, you will help shape Mudflap’s... ...for someone who wants to move beyond investigating individual cases and build the systems,... ...and team collaboration, we are open to remote team members who can travel periodically...Remote work$23 - $30 per hour
...Job Type Part-time Description Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum of... ...nationally recognized investigations firm offering surveillance, remote investigations, desktop intelligence, and specialty services to...Remote workHourly payPart timeSecond jobWork at officeFlexible hoursNight shift- A leading live shopping platform is seeking a Fraud Agent to help prevent and mitigate fraud on their platform. The ideal candidate will have 1 to 5 years of experience in customer service or fraud operations and a proactive problem-solving mentality. Team members can work...Remote jobWork from homeWeekend work
- ...Working remotely on a full-time basis, the Fraud Analyst will monitor fraud alerts, investigate suspicious transactions, and respond to customer inquiries while supporting fraud prevention efforts during the hours of 4:30 PM to 2:30 AM Central Time. Key responsibilities...Remote workFull timeWork experience placementWork at office
$56 - $64 per hour
...diploma or GED or Bachelor’s degree 8 years of experience in fraud, waste & abuse (FWA) investigations or special investigations unit (SIU) including 1 yr... ...of medical terminology and/or experience with CPT codes, and ICD-9, ICD-10 coding. Knowledge of suspected FWA trends...Contract workFor subcontractor
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