Remote Fraud & Abuse Investigator (CPC)
Sentara Healthcare Inc
- Remote job
Sentara Health Plan is seeking a Fraud and Abuse Investigator/Certified Professional Coder (CPC) to work remotely from eligible states. The role supports in-depth investigations across provider, pharmacy, employer, member, and broker interactions, plus audits and claims processing reviews. Requirements include a bachelor's degree (preferred) and CPC certification preferred or obtained within 12 months. Two years of audit/regulatory/healthcare experience are expected. #J-18808-Ljbffr Sentara Healthcare Inc
$25.6 - $42.67 per hour
...State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plan is currently hiring a Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time, permanent position (40 hours) Work hours: 8am to 5pm EST, M-F Location:...Remote workPermanent employmentFull timeTemporary workLive inCurrently hiringShift work- Centene Corporation in the United States is seeking an experienced investigator to independently lead complex fraud, waste, and abuse investigations across providers, members, pharmacies, and vendors. The role requires analyzing diverse data sources, developing investigation...Remote job
- ...Independently leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator... ...support corrective actions while working remotely. Key responsibilities Lead... ...preferred Relevant certifications such as AHFI, CFE, CPC, or CPMA preferred...Remote workFull time
$65k - $88.6k
...Fraud And Waste Professional 2 The Fraud And Waste... ...Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud And... ...are fortunate to offer a remote opportunity for this job... ...Clinical Certifications, CPC, CCS, CFE, AHFI)....Remote workBi-weekly payTemporary workApprenticeshipWork from homeHome officeMonday to Friday$65k - $88.6k
...an experienced Healthcare Investigator to join its industry leading... ...have a passion for combating Fraud, Waste, and Abuse in the Health Care Industry... ...at Home. While this is a remote position, occasional travel... ..., Clinical Certifications, CPC, CCS, CFE, AHFI) • Experience...Remote workFull timeTemporary workFor contractorsApprenticeshipWork experience placementWork at officeLocal areaWork from homeHome officeMonday to Friday$65k - $88.6k
## Fraud and Waste InvestigatorApplylocations: Remote Nationwidetime type: Full timeposted on: Posted Yesterdayjob... ...Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and... ...Clinical Certifications, CPC, CCS, CFE, AHFI).*...Remote workBi-weekly payWeekly payFull timeTemporary workWork at officeWork from homeHome officeMonday to Friday- ...analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid, Commercial,... ...you will not manage anyone. Strong investigators here come from healthcare payer/vendor... ...CFE). Certified Professional Coder (CPC). Accredited Health Care Fraud Investigator...Remote work
$15 - $25 per hour
...Fraud Analyst - Content & Reviews Abuse is a remote review track for evaluating AI outputs across fraud analyst content reviews abuse specialist operations workflows. Reviewers grade workflow correctness, policy adherence, and stakeholder fit; flag operational risk; and...Remote jobFor contractorsWork experience placement10 hours per week- ...Profile We offer remote work opportunities (AK, AR, AZ, CO... ...adjudicated DOD background investigation for this position. Veterans... ...and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the... ...Facets Certified Coder (CPC, CPC‑P, CCA, CCS‑P), AHFI,...Remote workContract workFor subcontractorInterim role
- ...Humana Inc. is seeking a Fraud and Waste Professional 2 to conduct investigations of fraudulent and abusive practices. The role involves coordinating with compliance, partners... ...preparing complex reports. The position is remote anywhere in the US with occasional travel for...Remote work
$64k - $68k
...We offer remote work opportunities (AK, AR, AZ, CO, FL, HI,... ...adjudicated DOD background investigation for this position.... ...and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the... ...Facets • Certified Coder (CPC, CPC-P, CCA, CCS-P), AHFI,...Remote workContract workTemporary workFor subcontractorInterim roleLocal areaShift work- ...Centene Corporation is seeking an investigator in Arkansas to tackle healthcare fraud and abuse activities. The role involves conducting thorough investigations, performing data analysis, and preparing reports for federal and state agencies. The ideal candidate should...Remote workFlexible hours
$65k - $88.6k
...Humana Inc. is seeking a Fraud and Waste Investigator to conduct investigations of fraudulent and abusive practices. The role is remote nationwide with standard 40-hour weeks and a pay range of $65,000–$88,600 per year. The ideal candidate will hold a Bachelor's degree...Remote work$161.8k - $242.6k
...important work of your career. About The Team Fraud Strategy is responsible for building... ...broader financial ecosystem from actors who abuse Stripe accounts for financial gain. What... ...is available either in an office or a remote location (35+ miles or 56+ km from a Stripe...Remote workWork at officeLocal areaWork from homeRelocation- ...Inc. is seeking an experienced Healthcare Investigator to join its industry-leading Special... ...role involves investigating fraudulent and abusive practices, assembling evidence,... ...candidates have 2+ years in healthcare fraud investigations, strong data analysis skills...Remote work
- ...Ellenco Estágios e Treinamentos is seeking a Fraud Analyst - Content & Reviews Abuse specialist contractor to evaluate AI outputs and ensure alignment... ...and capture actionable next steps for model training. Remote work options apply to the US, with a flexible schedule...Remote workFor contractorsFlexible hours
$85k - $105k
...Healthcare Fraud InvestigatorCGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. The candidate... ...litigation.Analyze data for evidence of fraud, waste and abuse.Review and evaluate referrals to determine the...Remote workWork experience placementWork at officeLocal area$85k - $105k
...Healthcare Fraud InvestigatorEmployment Type: Full-Time, Mid-Level Department: Litigation... ...CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government... ...data for evidence of fraud, waste and abuse.Review and evaluate referrals to...Remote workFull timeWork experience placementWork at officeLocal area- ...Levels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ...and prevention of healthcare fraud, waste and abuse (FWA). We are growing and looking for... ...Ability to work independently within a remote team, under minimal supervision Benefits...Remote workFull time
- Humana Inc. is seeking a Fraud and Waste Professional 2 to coordinate investigations of fraudulent and abusive practices across internal and external entities, assemble evidence... ...in support of adjudication. This is a remote opportunity in the United States with occasional...Remote job
- ...Conducting fraud, waste, and abuse investigations, the full-time remote Fraud Investigations Analyst will lead quality control efforts, manage regulatory deliverables, and ensure compliance with Medicaid standards while preparing documentation for regulatory inquiries...Remote workFull time
- Centene Corporation, a national leader in diversified healthcare, seeks a seasoned investigator to guide team members, investigate fraud, waste and abuse, and mentor staff. This remote role covers the continental United States and emphasizes compliance with CMS guidelines...Remote job
- Centene Corporation in Pennsylvania is seeking a Senior Investigator to independently lead complex fraud, waste, and abuse investigations across providers, members, pharmacies, and vendors using referrals, claims data, medical records, interviews, analytics, and other...Remote job
- Centene Corporation seeks an experienced Investigator to lead complex fraud, waste, and abuse investigations affecting providers, members, and vendors. You will analyze claims data, medical records, and interviews to identify schemes and overpayments, and guide investigations...Remote job
- Novig, located in New York, New York, is seeking a Fraud and Risk Specialist. The successful candidate will investigate multi-accounting, bonus abuse, and suspicious betting patterns, ensuring marketplace integrity. This full-time role offers a salary between $65K-$75K...Remote jobFull time
- Centene Corporation is seeking a senior investigator to independently lead complex fraud, waste, and abuse investigations across providers, members, pharmacies, vendors, and other entities. You will analyze claims data, medical records, and financial information to identify...Remote job
- ...the Role As our Senior Fraud Analyst for Consumer Lending... ...scale automated block and manual investigation policies. Advanced Risk... ...Activity Reports (SARs), loan abuse patterns, and system... ...dental, and vision plans Remote work environment, although we...Remote work
- ...enthusiastic and dedicated person to support the Fraud Risk Data Science Team within the Risk... ...payments, user trust/risk/fraud, or investigation/product abuse. Bachelors/Master's degree in Data... ...the San Jose area. HM will entertain remote candidates if no viable local...Remote workContract workLocal areaDay shift
- ...us. Job Description A Fraud Analyst I is responsible for... ...to prevent, deter, detect and investigate acts of fraud committed... ...ACH fraud, wire fraud, elder abuse fraud, kiting and unusual activity... ...Reviews and investigates Remote Deposit Capture transactions...Remote workHourly payContract workWork at officeLocal areaImmediate start
- ...London and Amsterdam. We are the first line of defense against fraud and abuse on the Plaid platform. Our mission is to ensure the safety... ...be responsible for responding to fraud and abuse events, investigating claims, and triaging incidents. We also partner with product...Full timeWork experience placementLocal area
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