Remote Behavioral Health Investigator: Fraud & Compliance
Centene Corporation
- Remote job
Centene Corporation is seeking an experienced candidate for a remote position that involves conducting reviews of medical records and claims to detect fraud, waste, and abuse. The ideal candidate will have a Master's Degree and at least 2 years of relevant experience. This role requires a robust understanding of billing codes and regulatory guidelines, as well as close collaboration with investigators. A broad benefits package is provided, including health insurance and flexible working arrangements. #J-18808-Ljbffr Centene Corporation
- Centene Corporation is seeking a remote Fraud Investigator to conduct reviews of medical records and claims to identify fraud and abuse. The role involves analyzing provider billing patterns and preparing recommendations based on findings. A Master’s Degree and relevant...Remote jobFraud
$107.7k - $199.3k
...Internal Investigations Manager You could be the one who... ...Centene is transforming the health of our communities,... ...practices, regulatory compliance, and risk mitigation.... ...: Certified Fraud Investigator preferred... ...approach to work with remote, hybrid, field or office...Remote workFraudFull timePart timeWork at officeFlexible hours$49.7k - $88.8k
UnitedHealthcare is looking for an Investigator to conduct compliance investigations related to agents and brokers. This role allows for telecommuting... ...independent investigation experience, with a focus in health care fraud. Responsibilities include documenting findings and...Remote jobFraud$49.7k - $88.8k
UMR in Minnetonka is seeking an Investigator responsible for investigating agent and broker... ...business lines. This role involves conducting compliance investigations, documenting findings,... ...experience, preferably in health care. The position offers a competitive...Remote jobFraud$56.2k - $101k
...records and claims, focusing on identifying potential fraud, waste, and abuse. The role is remote nationwide and requires a Master’s Degree along with 2... ...along with a comprehensive benefits package including health insurance and flexible work arrangements. Join Centene...Remote jobFraudFlexible hours- divvyDOSE is seeking an Investigator responsible for conducting compliance investigations on agent/broker complaints. The role involves documenting findings, conducting interviews, and reporting illegal activities as necessary. Candidates should have investigative experience...Remote jobFraud
$49.7k - $88.8k
United Health Group is seeking an Investigator to manage agent/broker complaints in compliance with state and federal regulations. This role involves conducting confidential investigations, documenting findings, and reporting illegal activities. Required qualifications...Remote jobFraud- ...treatment services that are in compliance with State and Federal... ...significant support around behavioral and mental health needs. Once hired on, there... ...Colorado court database, Medicare fraud database, Reference Checks,... ...needs. Must travel to remote work sites and must utilize...Remote workFraudTemporary workWork at officeFlexible hoursShift work
$81.7k - $113.4k
...Digital Fraud Investigator At Municipal Credit Union, we believe that an incredible culture... ...standards of loss prevention, regulatory compliance, and member protection.... ...including IP analysis, device fingerprinting, behavioral biometrics, and detailed log review....Remote workFraudLocal areaFlexible hours- ...Job category: Regulatory & Compliance At UnitedHealthcare, we're simplifying the health care experience, creating healthier... .... Growing together. The Investigator will be responsible for investigating... ...in a position investigating fraud (health care fraud...Remote workFraudMinimum wageFull timeWork experience placementLocal areaMonday to Friday
$60.2k - $107.4k
...Job category: Regulatory & Compliance At UnitedHealthcare, we're simplifying the health care experience, creating healthier... ...together. The Senior Investigator is responsible for identification... ...and prevention of healthcare fraud, waste and abuse. The Senior...Remote workFraudMinimum wageFull timeTemporary workWork experience placementLocal area- ...Warranty Claims Investigator Requisition ID:... ...repair services. Remote workforce position... ...improving and adhering to health, safety and... ...and exhibit these behaviors. WHAT WE'RE... ...United States. In compliance with the ADA Amendments... ...FROM RECRUITMENT FRAUD The only way to...Remote workFraudFull timeFor contractorsLocal areaFlexible hours
- ...Providing investigative support for special investigation unit (SIU) activities, the full-time... ..., and investigation of healthcare fraud, waste, and abuse (FWA), while working remotely to analyze information and ensure compliance with coding and billing guidelines. Key...Remote workFraudFull time
$72.8k - $130k
...Fraud, Waste, and Abuse Investigator Optum is a global organization that delivers care... ...will directly improve health outcomes by connecting people... ...external intelligence or behavior data, the medical... ...members, clients, legal, compliance, and other investigative...Remote jobFraudMinimum wageFull timeContract workWork experience placementLocal area- ...As our Senior Fraud Analyst for Consumer... ...mitigating fraudulent behaviors at the... ...block and manual investigation policies. Advanced... .... Regulatory & Compliance Liaison: Coordinate... ...performance bonus Health, dental, and vision plans Remote work environment,...Remote workFraud
- ...FLR PCHP- Parkland Community Health Plan Primary Purpose The purpose... ...Health Plan (PCHP) Special Investigations Unit is to implement an effective compliance program that includes prevention, investigation and pursuit of fraud, waste, and abuse violations. The...FraudWork at office
$46.99k - $112.2k
...Senior Healthcare Fraud Investigator We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose...Remote workFraudHourly payFull timeTemporary workWork experience placementLocal areaWork from home- ...As a full-time remote Fraud Investigator II, the successful candidate will be responsible for identifying and resolving fraudulent activity across... ...investigations of fraud alerts and claims, ensuring compliance with regulatory standards Required qualifications Bachelor...Remote workFraudFull time
- ...operational and analytical resource, the full-time Digital Fraud Investigator will work remotely to identify, investigate, and mitigate digital fraud... ...reports and maintain evidentiary materials in compliance with legal and regulatory requirements Collaborate with...Remote workFraudFull time
$63k - $84.42k
...Senior Fraud Investigator Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member...Remote workFraudLive inLocal area- ...considered. LOCATION: Remote- Must live in... ...~8% Match - 401K ~ Health benefits (HMO options)... ...looking for self-motivated investigator to be part of an... ...representative payees to ensure compliance as well as uncover and... ..., mismanagement, or fraud of beneficiary income....Remote workFraudHourly payExtra incomeFull timeTemporary workWork experience placementLive inWork at officeFlexible hoursShift work
$56.2k - $101k
...Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing... ...and coordinate with Health Plans on recommendations and further... ...holidays Flexible approach to work with remote, hybrid, field, or office schedules...Remote workFraudWork at officeFlexible hours$24.04 per hour
...analytical and detail-oriented Fraud Operations Analyst... ...with fraud and user behavior trends, identifying... ...best practices. Ensure compliance with anti-money... ...suspicious user behavior, and investigations. Work in cross‑... ...Ability to work a hybrid remote and in‑office schedule...Remote workFraudHourly payOngoing contractFull timeInternshipWork at officeImmediate start$56.2k - $101k
...members. Centene is transforming the health of our communities, one person at... ...Purpose Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning... ...a flexible approach to work with remote, hybrid, field or office work...Remote workFraudFull timePart timeWork at officeFlexible hours$56.2k - $101k
...Corporation is seeking a qualified candidate for a remote role focused on investigating healthcare fraud. You will conduct thorough investigations into potential... ...analytical reports, and work collaboratively with Health Plans. To qualify, you should have a Bachelor’s...Remote jobFraud- ...This role offers three weeks of remote company-provided training**... ...the Role:**As a Senior AML Investigator - Financial Crimes, you'll work... ..., ensuring regulatory compliance, and performing quality control... ...laundering, terrorist financing, fraud, and sanctions violations, escalating...Remote workFraudFull timeWork at officeLocal areaWork from home
$80k - $90k
...motivated and skilled Board Certified Behavior Analyst (BCBA) to join our... ...Job function Job function Health Care Provider Industries Hospitals... ...” roles. Behavioral Insights Fraud Analyst - Special Risk United... ...Behavioral Analyst (100% Remote) Florida, United States $26.50...Remote workFraudFull timePart time$65k - $88.6k
...Caring Community The Fraud and Waste Professional 2 conducts investigations of allegations of... ...external entities including compliance, internal business partners... ...fortunate to offer a remote opportunity for this... ...to achieve their best health – delivering the care and...Remote workFraudBi-weekly payFull timeTemporary workApprenticeshipWork from homeHome officeMonday to Friday$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 conducting... ...while providing the flexibility of remote work. The salary range is $78,320 to $128,160,...Remote workFraud$40k
...build a career in financial crime compliance. As an Entry-Level Anti-Money Laundering (AML) Investigator , you will review... ...laundering, terrorist financing, fraud, sanctions violations, and escalate... ...expectations ~ Comprehensive health, dental, vision, and defined...Remote workFraudOngoing contractFull timeWork at officeLocal areaWork from homeMonday to Friday
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