Remote Medicaid Fraud & Waste Investigator
Humana Inc
- Remote job
Humana Inc. is seeking a Fraud and Waste Professional who will conduct comprehensive investigations of suspected fraud in Medicaid-related processes. The role involves on-site audits, evidence preservation, and collaboration with law enforcement to support adjudication. Fully remote within the contiguous US with occasional travel, and a 40-hour workweek. Responsibilities include analyzing billing practices, developing detailed investigative reports, and partnering with cross-functional teams to #J-18808-Ljbffr Humana Inc
- ...Humana is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported, alleged, or suspected fraud involving the Medicaid program and related healthcare services. This remote role may require occasional travel to Humana offices for training...Remote work
- ...Humana, Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations of suspected fraud within the Medicaid program. You will coordinate with law enforcement... ...billing practices. The role is fully remote in the contiguous US, with potential...Remote work
- ...Humana Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported or suspected fraud in Medicaid programs. You will coordinate with law enforcement... ...complex reports while working remotely across the contigu US with occasional...Remote work
- ...Humana, Inc. is seeking a Fraud and Waste Professional to conduct investigations within the Medicaid-related context. The role is fully remote in the contiguous US with potential travel to Humana offices for training or meetings. You will analyze billing practices,...Remote work
$69.4k - $99.2k
...and capabilities. Summary The Medicaid Fraud, Waste & Abuse (FWA) Senior Analyst plays... ...follow-up questions, and supporting investigations through data analysis, documentation,... ...related activities (Up to 25%) Fully remote opportunity with the option to work anywhere...Remote workFull timeWork at officeFlexible hours$65k - $88.6k
...our caring community The Fraud and Waste Professional is responsible... ...conducting comprehensive investigations of reported, alleged or suspected... ...involving South Carolina's Medicaid Program. The Fraud and... ...Work Style Fully remote in the contiguous US, with...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Humana, Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported or suspected fraud related to Medicaid programs. The role requires coordinating with... ...ensure billing integrity. Fully remote in the contiguous US with periodic...Remote work
- ...Humana Inc. seeks a Fraud and Waste Professional to conduct comprehensive investigations of reported or suspected fraud within Medicaid programs. The role coordinates with law enforcement... ...integrity. The position is fully remote in the contiguous US, with occasional...Remote work
- Humana Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations and coordinate with law enforcement to protect the Medicaid program. This fully remote role supports nationwide program integrity efforts and requires strong analytical and communication...Remote job
- Humana Inc. is seeking a Fraud and Waste Professional to conduct investigations of reported, alleged or suspected fraud involving Medicaid programs. You will coordinate with law enforcement... ...and audit reports. This remote role uses data analysis to detect irregularities...Remote job
- Humana, Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported or suspected fraud impacting Medicaid programs. The role involves coordinating with... ...billing practices. The position is fully remote across the contiguous US with...Remote job
- ...SafeGuard Services (SGS), a subsidiary of Peraton, is seeking a Medicaid Fraud Auditor to join the SGS team. The role focuses on researching laws, conducting compliance audits across Medicaid cases, and identifying improper payments. Telework is available from any state...Remote work
$55.6k - $79.4k
...Manager 3+ years of experience detecting and investigating healthcare fraud ~2+ years providing excellent customer... ...Certified Fraud Examiner (CFE) Experience with Medicaid Management Information Systems (MMIS) Fully remote opportunity with the option to work anywhere...Remote workFull timeFlexible hours- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will... ...prevention of healthcare fraud, waste and abuse (FWA). We are... ...resultsSupport multiple clients with Medicaid, Medicare, Federal Employee... ...work independently within a remote team, under minimal...Remote work
- ...Providing investigative support for special investigation unit... ...the full-time Healthcare Fraud Investigator will focus on... ...investigation of healthcare fraud, waste, and abuse, while working remotely. Key responsibilities... ...of managed care, Medicaid, Medicare, and claim billing...Remote workFull time
- ...Senior Healthcare Fraud InvestigatorArlo Solutions... ...Government personnel.Location: REMOTE - Local to Washington,... ...care provider fraud, waste and abuse (FWA) and... ..., and standard investigation templates.Overpayment... ...experience, such as Medicare/Medicaid and VHA healthcare...Remote workContract workFor contractorsWork at officeLocal area
$77.5k - $99k
...provider is to assist those eligible Medicaid recipients to choose and pay for... ...The Program Integrity Fraud Audit & Investigations Analyst conducts fraud, waste, and abuse (FWA) investigations... ...required. Working Conditions: Remote work with occasional business travel...Remote workLocal area$32.03 - $45.7 per hour
...currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time, permanent... ...investigation of potential fraud, waste, and abuse. Conduct research... ...plans serving Medicare and Medicaid enrollees. Our quality provider...Remote jobHourly payPermanent employmentFull timeTemporary workLive inCurrently hiringShift work$66k - $106k
...Fraud Investigator- Medicare Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton... ..., and make referrals to recover fraud, waste, and abuse. We are looking to add an... .... Knowledge of Medicare and/or Medicaid programs and the rules, regulations, policies...Remote workContract workFor contractorsFlexible hoursShift workNight shift- ...State of South Dakota in Pierre, SD seeks a motivated MFANS Investigator to investigate Medicaid provider fraud, abuse, and neglect. The role focuses on safeguarding patients in nursing homes, hospitals, and pharmacies by conducting investigations and prosecuting cases...Hourly payFull time
- ...Peraton seeks a Fraud Investigator to conduct high‑level investigations in Medicare fraud, waste, and abuse. The role involves analyzing cases, interviewing witnesses, and coordinating with state and federal partners to develop referrals and corrective actions. Responsibilities...Remote work
$57.98k - $69k
...Financial Investigator I (NS)The North Carolina Department of Justice, led by the Attorney General of North Carolina, represents the... ...to perform investigations in the area of criminal and civil Medicaid fraud schemes, patient abuse or neglect, and misappropriation of recipient...Local areaNight shift- ...Solutions Organization LLC (SSO) is seeking a Licensed Professional Counselor to join our remote Healthcare Investigator team in Ohio. The role conducts investigations into Medicaid incidents, analyzes documentation, interviews involved parties, and ensures compliance...Remote workLocal areaWork from home
- The Office of the Attorney General in Florida's Medicaid Fraud Control Unit is seeking a Senior Investigator in Miami. The role involves independent investigations of Medicaid fraud and patient abuse, gathering evidence, interviewing witnesses, and preparing reports and...Work at office
- The North Carolina Department of Justice is seeking a Financial Investigator I (NS) to perform investigations into Medicaid fraud, patient abuse, and misappropriation of funds. The role involves data analysis of claims, reviewing financial documents, and interviewing witnesses...
- The Office of the Texas Attorney General, Medicaid Fraud Control Unit (MFCU), seeks a Sergeant to lead advanced criminal investigations into Medicaid provider fraud and nursing home cases. You'll coordinate with federal and state partners and assist in prosecutions as needed...Work at office
- .... The Sergeant position involves advanced criminal investigations of Medicaid provider fraud and nursing home related investigations for the Office of the Attorney General¿s Medicaid Fraud Control Unit (MFCU). Work involves conducting criminal investigations of violations...Full timeWork at officeRelocationNight shift
- ...Peraton is seeking a Fraud Investigations Manager to lead the SGS team in detecting fraud, waste, and abuse. The role involves directing investigators, overseeing case development for referrals, and supporting data requests for active investigations. Requirements include...Remote work
- ...Proactively identifying instances of fraud, waste, and abuse, the full-time Senior Fraud Analyst... ...anomaly detection algorithms in a remote work environment. Key responsibilities... ...approach to tasks Background in Special Investigations Unit (SIU) or Payment Integrity...Remote workFull time
- Sentara Health Plans is seeking an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) for a remote role. The position supports in-depth investigations of suspected fraud, waste, and abuse across providers, pharmacies, and members, with occasional...Remote job
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