Remote Investigator II — Fraud, Waste & Abuse
Point32Health
- Remote job
Point32Health is seeking an Investigator II for the Special Investigation Unit. This role involves leading investigations into fraud, waste, and abuse, requiring a Bachelor's degree and 3-5 years of experience in health insurance or fraud investigations. The Investigator will document findings, recommend educational strategies for providers, and develop methods to prevent future loss. Excellent communication and documentation skills are vital. Comprehensive benefits include medical coverage, retirement plans, and paid time off. #J-18808-Ljbffr Point32Health
- Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS... ...favorably adjudicated DOD background investigation for this position. Veterans,... ...development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department...Remote workFraudContract workFor subcontractorInterim role
$58.9k - $80.07k
...Healthfirst is looking for an Investigator within the Special Investigations Unit (SIU) to conduct investigations of alleged misconduct and fraud. This 100% remote role entails compiling data, writing reports, and presenting findings. Candidates must possess an Associate...Remote workFraud$51k - $80.07k
Healthfirst is looking for an Investigator within the Special Investigations Unit (SIU) to conduct complex investigations of alleged misconduct and fraud in a fully remote position. The ideal candidate must possess an Associate's degree in criminal justice or equivalent...Remote jobFraud- Healthfirst is hiring a Remote Investigator for the Special Investigations Unit. This role involves conducting complex investigations of alleged misconduct, compiling data into reports, and presenting findings to the Marketing Incidents Committee. Essential qualifications...Remote jobFraudWork at office
- Humana Inc is seeking an experienced Dentist for a remote position as the Dental Fraud and Waste Lead. You will investigate complex dental cases and perform clinical reviews related to fraud and abuse. The role also involves educating a team on dental standards. Required...Remote jobFraud
$86.3k - $118.7k
...Dentist to join their Dental SIU Team. The role involves investigating dental fraud, waste, and abuse cases, conducting clinical reviews, and providing... ...experience and an active dental license. This position is remote, with minimal travel expected. The salary range is...Remote jobFraud$66.33k - $145.86k
...individual contributor role supports complex investigations and contributes to organizational... ...plays a key role in identifying fraud risks, supporting program integrity efforts... ...financial losses related to fraud, waste, and abuse. Performs complex investigations related...FraudHourly payFull timeTemporary workLocal area- ...As a full-time remote Fraud Investigator II, the successful candidate will be responsible for identifying and resolving fraudulent activity across various products and services, engaging with members to mitigate risk, and managing end-to-end investigations to safeguard...Remote workFraudFull time
$65k - $88.6k
Become a part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste... ...Humana Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100...Remote workFraudBi-weekly payWeekly payFull timeTemporary workApprenticeshipWork from homeHome officeMonday to Friday- Neier Inc. seeks a Technical Abuse Investigator to detect and disrupt malicious use of its platform. Responsibilities... ..., with expertise in domains like AI misuse or fraud, as well as proficiency in SQL and Python. Remote work is available for candidates within the U.S....Remote workFraud
- ...Fraud, Waste, and Abuse Investigations Manager The Fraud, Waste, and Abuse Investigations Manager handles the operational activities related to Pharmacy Compliance, FWA. This will require close partnership and collaboration with a cross-functional group of leaders....FraudLocal area
- Golden1 is seeking an experienced Investigator II in Sacramento, CA, responsible for investigating... ...suspicious activities related to fraud. This role includes analyzing evidence,... ...prevention or investigations. The position is remote within California only and offers competitive...Remote jobFraudHourly pay
$78.32k - $128.16k
Elevance Health seeks an Investigator II in Los Angeles to investigate healthcare fraud cases, requiring a BA/BS and at least 3 years of experience. The role entails... ...collaboration while providing the flexibility of remote work. The salary range is $78,320 to $128,160,...Remote workFraud$86.3k - $118.7k
...Atlanta, Georgia is seeking an experienced Dentist for a remote position with the Dental Fraud and Waste Team. The role involves conducting clinical reviews... ...fraud and providing education to a team of dental investigators. The ideal candidate must have a DDS or DMD degree,...Remote jobFraud$33.86 - $37 per hour
...TITLE: INVESTIGATOR II STATUS: NON-EXEMPT REPORTS TO: SUP- FRAUD OPERATIONS DEPARTMENT: FRAUD PREVENTION AND RISK INVESTIGATIONS JOB CODE: 1145... ...PAY RANGE: $33.86 - $37.00 HOURLY LOCATION: Remote in CA only GENERAL DESCRIPTION: The Investigator...Remote workFraudHourly payWork at officeLocal area- ...sponsorship. Responsibilities Responsible for fraud and abuse detection activities for the state... ...be responsible for day‑to‑day Provider investigation-related inquiries. Utilizes... ...regulatory agencies. Cooperates with fraud, waste and abuse efforts with external business...FraudContract workLocal areaMonday to FridayNight shiftWeekend work
$67.64k - $101.46k
Elevance Health is seeking an Investigator II in Atlanta, Georgia, to lead investigations into healthcare fraud. The role combines in-office collaboration 1-2 days a week with remote flexibility. Responsibilities include conducting claim reviews, developing investigations...Remote workFraudWork at office2 days per week1 day per week$86.3k - $118.7k
...looking for an experienced Dentist to join their Dental Fraud and Waste Lead team. This remote position involves conducting thorough clinical reviews... ...complex dental cases and collaborating with a team of investigators. The ideal candidate will possess a DDS degree, at...Remote jobFraud- Humana Inc is looking for an experienced Dentist to join their Dental SIU Team as a Fraud and Waste Lead. This remote role involves conducting clinical reviews, preparing reports, and providing education on dental standards. The ideal candidate must have a DDS or DMD and...Remote jobFraud
- ...experienced Dentist for their Dental Fraud and Waste Lead role. This position involves conducting... ...on industry standards. Though mainly remote, occasional travel to offices is... ...communication skills, and have both clinical and investigative experience. Benefits include 401k...Remote jobFraud
$86.3k - $118.7k
Humana Inc is looking for an experienced Dental Fraud and Waste Lead to join their remote team. The role involves investigating complex dental cases, completing clinical reviews, and educating a team on dental standards. Candidates should have a DDS or DMD and at least...Remote jobFraudWork at office- 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 jobFraud
$80.74k - $121.11k
...Investigator II Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality... ...for leading complex provider investigations related to fraud, waste, and abuse, and developing action plans to address the investigative...FraudContract workWork at officeWork from homeFlexible hours$80.06k - $106.06k
Special Investigations Unit Investigator II (Healthcare) The SIU Investigator II is responsible for investigating and analyzing suspected cases of fraud, waste, and abuse within the healthcare environment. This role conducts comprehensive investigations, leveraging data...FraudWork experience placementWork from homeMonday to Friday- ...Investigator II The School District of Philadelphia is committed to becoming the fastest improving District in the country... ...investigations related to allegations of corruption, fraud, criminal activity, waste, abuse, mismanagement, misconduct, conflicts of interest and...FraudFull timeContract workFor contractorsWork experience placementWork at officeLocal area
$63k - $68k
Coventbridge-Group is seeking a Medicaid/Medicare Program Integrity Analyst II for a remote position based in Grove City, OH. This role necessitates evaluating potential fraud cases and documenting findings, requiring excellent research and analytical skills. The ideal...Remote jobFraud$29.37 - $41.12 per hour
Fraud Investigator II Salal 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,...Remote workFraudHourly payLocal areaWork from home$63.59k - $121.53k
Life Special Investigations Unit Investigator I (Mid-Level) - Medicare Supplement Fraud Waste & Abuse Join to apply for the Life Special Investigations Unit Investigator I (Mid-... ...Investigations LAW ENFORCEMENT INVESTIGATOR II - 41000697 1 Criminal Investigator (Special...FraudFull timeContract workH1bWork at officeRelocation packageFlexible hours- ...Investigating allegations of potential healthcare fraud and abuse, the full-time SIU Investigator will conduct investigations,... ...detailed reports while working remotely, preferably from Ohio. Key responsibilities... ...investigations of potential waste, abuse, and fraud in healthcare...Remote workFraudFull time
- ...Providing investigative support for special investigation unit (SIU) activities, the full-time Healthcare Investigator... ..., detection, and investigation of healthcare fraud, waste, and abuse (FWA), while working remotely to analyze information and ensure compliance with...Remote workFraudFull time
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