Lead Data Scientist, Fraud & Billing (Remote)
Machinify Inc.
- Remote job
A healthcare intelligence firm is seeking a Staff Data Scientist responsible for leading the development of classical ML and GenAI systems in healthcare payments. The role involves building pipelines for billing error detection, collaborating with SMEs, and ensuring high-impact delivery. Ideal candidates have over ten years of experience in data science, including five in leadership, and possess strong problem-solving skills. The firm offers remote work flexibility and competitive benefits. #J-18808-Ljbffr Machinify Inc.
$140k - $160k
...San Diego (La Jolla/UTC); Remote About Prism Data Prism Data is building the... ...scores including the market-leading CashScore® for credit risk... ...product. As such, the Lead Data Scientist plays a uniquely central... ...scores, alternative data, fraud prevention, etc.). Cash flow...Remote workFraudWork experience placementLocal area$220k - $250k
ABOUT APPOMNI AppOmni prevents SaaS data breaches by delivering end-to-end SaaS security... ...THE ROLE AppOmni is looking for a Lead Data Scientist, Risk Intelligence & AI to engineer,... .... * Experience in security, identity, fraud, abuse, trust & safety, risk modeling,...Remote workFraudImmediate start- ...investigation of healthcare fraud, waste, and abuse (FWA), while working remotely to analyze information... ...compliance with coding and billing guidelines. Key responsibilities Develop leads and conduct assessments... ...including interviews and data analysis Complete investigations...Remote workFraudFull time
- ...$16 billion. With investment fraud and BEC scams at the forefront... ...and fighting fraud. As a Senior Data Engineer, you’ll own the... ...serve as the source of truth for billing, revenue, usage, and customer... ...Wellness reimbursement of $300/year Remote worker reimbursement of $300/...Remote workFraudFlexible hours
- ...investigations to protect the agency from fraud, waste, and abuse. The... ...will directly report to the Data Analytics Manager and work... ...claims data to identify aberrant billing trends for providers.... ...5, 2026 Hybrid: in‑office and remote work, frequency determined by...Remote workFraudWork at officeShift work
- ...unusual utilization patterns and potential fraud by healthcare providers. You will conduct... ...record reviews to ensure accurate billing, compliance with payer regulations, and integrity... ...and coordinate actions as needed. Data Analysis and Trending : Analyze performance...Remote workFraudFull timeWork at office
$87.7k - $157.8k
Centene Corporation is seeking a qualified candidate to manage strategic fraud, waste, and abuse activities in New York. Responsibilities include monitoring billing integrity and leading a team for pre-payment investigations. Ideal candidates should possess a bachelor’s...Remote jobFraud- ...Investigator responsible for investigating fraud, waste, and abuse. This role... ...experience and can be performed remotely in several U.S. states. The ideal... ...background in healthcare claims analysis, data analysis techniques, and knowledge of billing regulations. Responsibilities...Remote jobFraud
$212k - $265k
...scale. We aren't just a billing layer; we are becoming... ...for the better. About Data Engineering at Headway... ...closely with Data Scientists, Analysts, and core Software... ...data models. You will lead complex, multi-functional... ...and recruitment fraud, please note that Headway...Remote workFraudWork at officeWork from homeFlexible hours- ...Job Description This is a remote position, with occasional travel... ..., medical record review, and billing compliance activities for Indiana... ...preliminary findings to the Lead Reviewer. Identify potential... ...of healthcare claims data and fraud, waste, and abuse preferred....Remote workFraud
- ...seeking an Investigator to develop, implement, and manage strategic activities against fraud, waste, and abuse. You will ensure compliance and oversee billing integrity while leading a team in investigations. This role requires a bachelor’s degree and over 4 years of relevant...Remote jobFraudFlexible hours
- Centene Corporation in California seeks a dedicated individual to lead strategic fraud, waste, and abuse initiatives within our health plans. In... ..., monitor processes for integrity, and ensure compliance in billing. The ideal candidate holds a Bachelor's degree and has over...Remote jobFraud
- Centene Corporation in Austin, Texas is seeking a skilled professional to lead strategic fraud management initiatives. The role requires a thorough understanding of compliance, billing, and claims payment integrity. The ideal candidate will possess a Bachelor's degree...Remote jobFraudFlexible hours
$80k - $90k
...treatment goals. Collect and analyze data to measure progress and make... ...is a must Experience with billing and insurance companies is a... ...Analyst” roles. Behavioral Insights Fraud Analyst - Special Risk United... ...Behavioral Analyst (100% Remote) Florida, United States $26.50...Remote workFraudFull timePart time- ...records, documentation, and billing data Collaborate with interdisciplinary... ...work with Pennsylvania's leading Quality Improvement... ...for vulnerable populations Remote work - enjoy the convenience... ...policies and identify potential fraud, waste, or abuse. Review clinical...Remote workFraudFull timeTemporary workWork at officeWork from home
- ...Process draw down and tax Perform OFAC and Fraud Maintain adequate balances at Federal... ...and update wire callback End of day Create billing setup/email notification within eWire for... ...initiate email notification with client Remote capture review for transaction fraud Stop...Remote workFraudContract workNight shift
$26.14 - $36.59 per hour
...Inpatient Coder - Remote Part Time, 20 Hours/Week We are hiring for an inpatient coder... ...a daily basis in order to facilitate the billing process within the established timeframes... ...via email or text. If you suspect fraud, please contact us at ****@*****.***....Remote workFraudPart timeWork at office- ...options from anywhere in the U.S. The successful candidate will document their findings and collaborate with team members to address billing issues. Benefits include competitive hourly pay, a comprehensive package, and potential for stock purchase. #J-18808-Ljbffr Crains...Remote jobFraudHourly payFull time
- ...General, focused on analyzing claims data and supporting fraud prevention efforts. This hybrid role requires... ...a combination of in-office and remote work, with responsibilities including... ...data analysis to identify suspicious billing trends. Candidates should have relevant...Remote workFraudWork at office
- ...and utilization reviews to protect the agency from fraud, waste, and abuse, requiring a mix of in-office and remote work based on supervisor needs. Ideal candidates... ...claims. The position is essential for analyzing billing trends and facilitating investigations. #J-18808...Remote workFraudWork at office
$49.7k - $88.8k
...Investigator to oversee the identification, investigation, and prevention of health care fraud, waste, and abuse. The role involves analyzing claims data to detect aberrant billing practices and conducting related field investigations. Successful candidates will have at...Remote jobFraudWork at office- ...role involves conducting detailed reviews of medical records, documenting findings, and collaborating with team members on trends in billing and coding issues. Applicants must have a high school diploma and an active coding certification with 2+ years of relevant...Remote jobFraudFull timeFlexible hours
- ...people. DCH serves as the lead agency for Medicaid,... ...safeguard the agency from fraud, waste, and abuse. The... ...direct report to the Data Analytics Manager. The... ...data to identify aberrant billing trends for providers to... ...requires in-office and remote work with the approval...Remote workFraudWork at office
- ...Revenue Cycle Trainer to lead the development and... ...Hybrid (in-office and remote) Department: Operations... ...hires across coding, billing, cash posting, AR, and... ...Analyze operational data to identify errors, denials... ...aligned with HIPAA, OIG, and Fraud, Waste & Abuse...Remote workFraudFull timeWork at officeImmediate start
- ...includes scheduling, registration, coding, billing, and other essential revenue functions... ...Duke Health. This position is 100% remote. All Duke University remote workers must... ...to academic medical centers, HIPAA, and fraud and abuse with periodic updates. Assist in...Remote workFraudWork at office
- Machinify is a leading healthcare intelligence company with expertise across the... ...costs. We are seeking a Staff Data Scientist. This role will be responsible for... ...systems that generate and validate billing error, audit, and fraud concepts in healthcare payments. You...Remote jobFraudFlexible hours
$52k - $60.4k
...for compliance with carrier and billing regulations. - Performs... ...and regulations, particularly fraud, waste, and abuse and privacy... ...time - Monday-Friday - Fully remote with occasional in-person meetings... ...in the future based on market data, internal equity, and the...Remote workFraudFull timeMonday to Friday$80k
...Associate Director or designee, the Fraud, Waste, and Abuse (FWA) Auditor... ...activities to develop leads and detect aberrant billing practices, including data mining, claims analysis, and medical... ...all other aspects of the job are remote. Responsibilities Responsibilities...Remote workFraudFull timeWork at officeShift work$24 - $30 per hour
...CCT Manager Work Type: Remote/Field POSITION SUMMARY:... ...Libertana Home Health as the Lead Organization that covers Los Angeles... ...Presents all time keeping to billing department weekly. #... ...credentials up to date. # Reports fraud and abuse. # Knowledge of...Remote workFraudWork at officeLocal area$70k - $90k
...a Senior Investigator – Lead Validation (Healthcare FWA... ...and analyzing potential fraud, waste, and abuse through advanced data-driven methods. You will... ...suspicious provider behavior and billing anomalies. The position... .... This is a fully remote, detail-intensive role for...Remote jobFraudFull timeFlexible hours
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