Remote Fraud & Compliance Claims Auditor II
Elevance Health
Miami, FL
- Remote job
Elevance Health is seeking a Clinical Provider Auditor II to identify issues posing potential risk related to fraud and abuse. Primary location Atlanta, GA and a virtual/ hybrid arrangement offering flexibility and required in-person training sessions. You will examine claims for compliance, review medical records before payment, research coding issues, collaborate with the Special Investigation Unit, and help train new associates. #J-18808-Ljbffr Elevance Health
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Fraud & Compliance Claims Auditor II in Miami, FL vacancy
$70k - $90k
Legal Billing Auditor at CURE Auto Insurance (Citizens... ...outside counsel to ensure compliance with billing guidelines... ...trial preparation, and claims handling processes.... ...insurance, and identity & fraud protection. 24/7... ...schedule: onsite 4 days/week, remote 1 day/week. Locations:...Remote workClaimsFraudWork at officeLocal areaFlexible hours1 day per week- Qlarant is seeking an investigator to ensure integrity in claims processing by conducting audits and investigations. You will gather data... ...and potential legal/audit use. The role emphasizes identifying fraud, waste, and abuse, with adherence to industry regulations and...ClaimsFraud
- ...do. This position is remote within our NC, SC, VA... ...this role matters Fraud can have a lasting impact... ...a Fraud Investigator II at Truliant Federal Credit... ..., validate member claims, and document clear, accurate... ...Truliant, including Compliance and Legal, to reduce losses...Remote workClaimsFraudFull timeTemporary workLocal areaFlexible hours
Truliant Federal Credit Union
Whitakers, NC2 days ago $50 - $60 per hour
...is seeking an Attorney Auditor to join our team. You’... ..., reasonableness and compliance with agreed upon fee structure... ...with law firms and claims staff to determine the... ..., and identity & fraud protection 24/7 Employee... ...flexibility to work remotely 1 day per week....Remote workClaimsFraudHourly payPart timeWork at officeLocal areaWork visaFlexible hours1 day per week- ...Safety Update Reports (PSURs) in compliance with regulatory requirements.... .... ISO 9001 Internal Auditor / Lead Auditor Certification.... ...this position. Recruitment Fraud Alert We are aware of phishing... ...receive a suspicious message claiming to be from Medtronic, do not...Remote workClaimsFraudTemporary workImmediate startFlexible hours
Medtronic Plc
United States4 days ago - ...Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through... ...ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or...Remote workClaimsFraudContract workWork at office
DaMar Staffing
Fort Lauderdale, FL4 days ago - Machinify is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy...Remote jobClaimsWork from home
- Clinical Provider Auditor II Primary Location(s): Atlanta, GA Virtual: This role enables associates... ...that may pose potential risk associated with fraud and abuse. How you will make an impact: Examines claims for compliance with relevant billing and processing guidelines...ClaimsFraudFull timeTemporary workWork at officeLocal area1 day per week
$66k - $106k
...make referrals to recover fraud, waste, and abuse.... ...Peraton is looking for an Auditor/Investigator . The... ...dollars. This is a remote position, candidates must... ...Columbia, and Part B claims in the counties of Arlington... ...systems. ~ Ensure compliance with CMS Program...Remote workClaimsFraudContract workFor contractorsFlexible hoursShift workNight shift$74k - $135k
...coding and billing audits, disputes, claims analysis, investigations, compliance reviews, and litigation support.... ...reimbursement, contractual, regulatory, and fraud, waste, and abuse risks from... ...10-CM, ICD-10-PCS, CPT, HCPCS Level II, modifiers, units, revenue codes, and...ClaimsFraudContract workLocal areaFlexible hours- Auditor US Defense Commissary Agency (Part of... ...prevent and detect fraud, waste and abuse in... ..., financial, and compliance audits by developing... ...Financial Management Level II Certification.... ...eligible: Yes Remote work eligible: No... ...support your educational claims. Transcripts....Remote workClaimsFraudPermanent employmentFull timeContract workPart timeWork at officeRelocationTrial period
US Defense Commissary Agency
Fort Lee, VAa month ago - ...of Insurance Division Fraud Control Group Job Classification... ...Title Attorney II (NS) Position Number 65... ...routine office and up to one remote workday per week. The... ...matters, ensuring compliance with applicable laws and... ...related matters, including claims, underwriting, and...Remote workFraudWork at officeLocal areaNight shift
State of North Carolina
Wake Forest, NC5 days ago - ...classified as hybrid, onsite or remote. While the majority of our... ...limited to: Customer Service, Claims Processors, and Correspondence... ...Accountant (CPA) Certified Internal Auditor (CIA) Certified Information... ...2 - senior internal auditor II Assist IA manager with...Remote workClaimsFull timeWork experience placement1 day per week
$75k - $85k
...Summary / Job Purpose: The Staff Auditor II’s primary focus is to perform... ...4 days in the office, 1 day remote. Essential Functions: Perform... ..., financial reliability and compliance with applicable directives... ...products, risk engineering and claims management services that...Remote workClaimsTemporary workWork experience placementWork at officeLocal areaFlexible hours$63.44k - $95.16k
...Overview The Analyst II role is an experienced... ...Workers' Compensation claims across multiple jurisdictions... ...at a core location, 4 remote days). Applicants must... ...Compensation claims in compliance with applicable state... ...appropriate. Identify potential fraud indicators and elevate...Remote workClaimsFraudFull time- ...Senior Medical Coding Outpatient Auditor to lead coding-focused audit... ...coding accuracy, and ensure compliance with outpatient coding and... ...The role involves researching claims anomalies, applying CPT/HCPCS... ...to improve audit strategies. Remote work with occasional travel is...Remote workClaims
Humana
New York, NY9 hours ago $78k
...Fraud Investigator II Minimum Salary US-MA-Westborough Job Location 1 month ago(8/19/2026 3:29 PM... ...and data analysis techniques utilizing claims data to detect aberrancies and outliers... ...records and claims data to ensure compliance with applicable regulations, contracts...ClaimsFraudFull timeWork at officeShift workUMass Med School
Westborough, MA1 day ago$29.33 per hour
...For positions that work remotely or in a hybrid work-from-home... ...experiences, then our Mercury Insurance Claims team could be the place for... ...support, the Claims Specialist II takes the lead in guiding... ...indemnity exposure or suspected fraud to supervisors for further review...Remote workClaimsFraudHourly payLocal areaWork from homeMonday to FridayMercury Insurance Services, LLC
United States5 days ago- ..., WA, and WI This is a remote position . Client Environment... ...Focus – AR Specialist II (Pediatric Hospital &... ...role requires balancing claim follow-up, appeals processing, and payer compliance while ensuring accuracy... ...who are excluded due to fraud, abuse, or other...Remote workClaimsFraudWork at officeMonday to Friday
Currance Inc
Irvine, CA6 days ago - ...Internal Auditor II The Internal Auditor II provides independent, objective assurance and... ...risk management, internal control, and compliance processes across academic, administrative... ...trends, and support risk assessment and fraud-detection efforts. Draft clear, well-...FraudWork at office
Albany State University
Albany, GA5 days ago - Daifuku North America is seeking an Internal Auditor II to lead and support internal audits across IT general controls, finance and compliance. The role involves coordinating with the... .... Hybrid work arrangement with limited remote days is available. #J-18808-Ljbffr...Remote work
- ...Conducting thorough fraud, waste, and abuse (FWA) investigations, the full... ...Investigation Unit Investigator will review claims data, medical records, and... ...with stakeholders to ensure compliance and support case resolution in a remote setting. Key responsibilities Conducts...Remote workClaimsFraudFull time
Virtual Vocations Inc
United States3 days ago - ...understanding for research purposes (in compliance with national laws,... ...investigator initiative studies (IIS) and facilitate IIS related... ...learn more: Recruitment Fraud Alert We have recently become... ...offer or communication claiming to be from AbbVie, please do not...Remote workClaimsFraudWork at officeLocal areaImmediate start
AbbVie
United States4 days ago - Qlarant is seeking an Auditor/Investigator to ensure the integrity of claims processing, collect data for audits, and identify fraud, waste, and abuse. You will interview witnesses, review documentation, and prepare comprehensive reports for management. Minimum Bachelor...ClaimsFraud
$130k - $195k
...includes base pay range and details about remote work and licensure. The employer is a... ...injury defense, workers’ compensation fraud claims, workers’ compensation insurance coverage... ...with applicant authorization in compliance with laws. Job function and industry...Remote workClaimsFraudFull timeJobot
Minneapolis, MN5 days ago- ...clinical affairs, healthcare compliance, reimbursement, and market access... ...for our breakthrough Class II/III neurostimulation devices and... ...with HCPs, anti-kickback and fraud and abuse considerations, transparency... ...-world evidence, promotional claims, labeling, and interactions...Remote workClaimsFraudContract workWork from home
Onward Medical
United States4 days ago $70k - $105k
...Job Description Actuarial Analyst II - Reserving - P&C 100% Remote (U.S. Based) $70,000 - $105,000... ...working closely with Finance, Accounting, Claims, and senior actuarial leadership.... ...reserving workflows • Respond to auditor and cross-functional business requests...Remote workClaimsThe Jonus Group
Henderson, NV2 days ago- ...Working remotely in a full-time capacity, the Auto Liability Adjuster... ..., and settle Auto Liability claims, focusing on both first- and... ...-party claims while ensuring compliance with coverage and legal liability... ...claims for potential fraud and collaborate with the Special...Remote workClaimsFraudFull time
Virtual Vocations Inc
United States3 days ago - ARMStrong Insurance Services is seeking a Premium Auditor to support our growing team. You will work from home with travel to policyholder locations within a limited territory, auditing financial records for workers’ comp, GL, garage, and auto lines. Ideal candidates have...Remote jobFraudWork from homeFlexible hours
- Qlarant is seeking a detail-oriented investigator/auditor to ensure integrity and accuracy of claims processes. You will collect data for audits/investigations... ...required with 2-4 years of experience; healthcare fraud experience desired and Medicare knowledge preferred....ClaimsFraud
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Fraud & Compliance Claims Auditor II. Be the first to apply!
