Remote Healthcare Fraud Investigator
Centene Corporation
- Remote 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 reports, and collaborating with compliance, legal, and external agencies to support corrective actions, recoveries, and case resolution while ensuring compliance with laws and company standards. #J-18808-Ljbffr Centene Corporation
- ...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
$65k - $88.6k
...Healthcare Investigator Humana is looking for an experienced Healthcare Investigator to join its... ...all do you have a passion for combating Fraud, Waste, and Abuse in the Health Care... ...information. Travel: While this is a remote position, occasional travel to Humana'...Remote workTemporary workWork at officeLocal areaWork from homeHome office- 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, etc) will depend on experience and... ...and prevention of healthcare fraud, waste and abuse (FWA). We are growing... ...Ability to work independently within a remote team, under minimal supervision Benefits...Remote work
- ...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... ...but you will not manage anyone. Strong investigators here come from healthcare payer/vendor...Remote work
- ...Centene Corp. seeks an SIU Investigator to conduct fraud, waste and abuse investigations across referrals, claims data and medical records. You will... ...in the U.S. without visa sponsorship now or in the future. Remote options are available within the U.S. #J-18808-Ljbffr...Remote workVisa sponsorship
- ...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 of fraud, prepare detailed reports, and collaborate with clients and internal teams while mentoring...Remote workFull time
$79.56k - $115.72k
...an exciting place to be within the healthcare industry. As a member of Mass General... ...Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving... ...generally 8:30-5:00 PM Eastern Time Remote workspace requirements, including privacy...Remote workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work$79.56k - $115.72k
...an exciting place to be within the healthcare industry. As a member of Mass General... ...Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving... ...generally 8:30-5:00 PM Eastern Time Remote workspace requirements, including...Remote workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work- 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
$97.7k - $162.8k
...Do 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... ...investigations and referrals of suspected healthcare fraud for potential action. Utilize...Local area- ...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
- ...Highmark Health is seeking an experienced professional to develop and maintain an anti-fraud program, conduct investigations into fraud, waste and abuse, and coordinate training and reporting across the organization. The role involves interviews, field investigations,...
- ...A healthcare organization is looking for a Special Investigations Unit Investigator II to investigate fraud and abuse in the healthcare environment. This role conducts thorough investigations leveraging data analytics, ensuring compliance with regulations, and supports...
$85k - $105k
...Healthcare Fraud Investigator CGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently...Work experience placementWork at officeLocal area- ...Ardelle Associates is seeking paralegals with experience in healthcare fraud and criminal and civil cases to support the U.S. Attorney's... ...using various databases and sources; identifies subjects to investigate and develops leads; conducts interviews; collects and processes...Full timeFor contractorsWork experience placementInterim roleWork at officeLocal areaMonday to Friday
- ...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
- ...State of Colorado’s Department of Law seeks a Compliance Investigator II for the Medicaid Fraud Control Unit to lead complex civil and criminal investigations into healthcare fraud, abuse, and neglect. You will analyze financial, medical, and investigative data, develop...
- ...Blue Shield of CA invites applications for the Special Investigations Investigator, Consultant role in our SIU. You will conduct investigations into healthcare fraud, waste, and abuse, report findings to the SIU manager, and ensure compliance with policies and laws. The...Work at office2 days per week
- 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
- ...CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit to lead high-level investigations into healthcare fraud and abuse. The role spans national scope with multi-line investigations and collaboration with medical directors and law enforcement...Full time
- ...CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit to lead complex healthcare fraud investigations on a national scale. You will conduct proactive data mining, analyze claims in depth, and collaborate with Medical Directors to determine...
- ...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
- ...professional to develop and maintain the organization’s anti-fraud program, conduct investigations into fraud, waste, and abuse, and coordinate with law... .... The ideal candidate will have at least 3 years in healthcare fraud investigations, strong data-mining capability,...
- ...Employment Type: Full‑Time, Experienced Department: Litigation Support Job Overview 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 ask questions to successfully...Full timeFor contractorsInterim roleLocal areaFlexible hours
- ...Highmark Health seeks a dedicated investigator to develop and maintain an anti-fraud program, conduct investigations into fraud, waste and abuse, and coordinate with law enforcement and regulatory bodies. This role requires field work, interviews with providers and members...
- ...Blue Shield of CA is seeking a Special Investigations Investigator, Consultant to join the SIU team in Oakland. You will conduct investigations into health care fraud, waste, and abuse, adhering to company policies, legal requirements, and applicable regulations. The role...
$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... ...stronger policies and controls to reduce risk. This is a remote position , offering flexibility to work from home. However,...Remote workHourly payLocal areaWork from home- ...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
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Healthcare Fraud Investigator. Be the first to apply!
- bank fraud investigator Brooklyn, NY
- fraud investigator Brooklyn, NY
- procurement specialist remote Brooklyn, NY
- physician consultant remote Brooklyn, NY
- remote insurance agent Brooklyn, NY
- remote data manager Brooklyn, NY
- training manager remote Brooklyn, NY
- remote customer service advisor Brooklyn, NY
- it manager remote Brooklyn, NY
- contract specialist remote Brooklyn, NY

