Remote Healthcare Fraud Investigator II
Elevance Health
- Remote job
Elevance Health is seeking an Investigator II to identify and develop healthcare fraud cases, recover funds, and work with law enforcement. The role emphasizes data-driven reviews of claims, coding accuracy, and collaborative investigations across programs. The ideal candidate has a BA/BS and 3+ years in investigations, with advanced Excel skills and CPT coding familiarity. Hybrid work setup with periodic in-person training supports ongoing professional development. #J-18808-Ljbffr Elevance Health
- ...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...Suggested
- ...Clinical Fraud Investigator II Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity... ...and medical records prior to payment. Researches new healthcare related questions as necessary to aid in investigations....SuggestedTemporary workWork at officeLocal area2 days per week1 day per week
$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... ...shape 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- A financial institution is seeking a Fraud Investigator II to safeguard members from financial crime. This remote position requires strong analytical and investigative skills. Candidates should have over three years of banking experience and two years in fraud or financial...Remote job
$59.72k - $71.66k
...Company: New Hampshire Mutual Bancorp Title: Fraud Analyst II Location: Remote based in New Hampshire Position Details: Full Time, Monday... ...assets. In this remote New Hampshire-based role, you’ll investigate suspicious activity, spot emerging fraud trends, and...Remote workFull timeMonday to Friday- ...Peraton’s SafeGuard Services (SGS) is seeking a Fraud Investigator to conduct complex investigations into medical professional services, develop cases for potential referrals, and coordinate with law enforcement and other agencies. The role requires independent judgment...Remote work
- ...Peraton seeks a Fraud Investigator for SafeGuard Services to conduct complex investigations of medical providers and develop actionable cases for law enforcement referrals and overpayment recovery. The role requires strong investigative, communication, and organizational...Remote work
$65k - $88.6k
...our caring community The Fraud and Waste Professional is responsible... ...conducting comprehensive investigations of reported, alleged or... ...Responsibilities Analyze healthcare payment methodologies,... ...Waste Work Style Fully remote in the contiguous US, with occasional...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$115k
...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support a mission focused on protecting Veterans and taxpayer dollars... ...rapid-response oversight initiatives. This position is remote and candidates must be local to Washington, DC . The Senior...Remote workFor contractorsLocal area- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ...investigation and prevention of healthcare fraud, waste and abuse (FWA). We are... ...to work independently within a remote team, under minimal...Remote work
- ...Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention, detection, and investigation... ...healthcare fraud, waste, and abuse, while working remotely. Key responsibilities Conducts...Remote workFull time
- ...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...Remote work
- ...To support the DVA VHA in establishing a Fraud Rapid Response Center, the remote Senior Healthcare Fraud Investigator will lead case development by reviewing analytics-generated leads, preparing decision-ready referral packages, and collaborating with federal investigators...Remote work
- ...Centene Corporation is seeking an investigator to conduct fraud, waste, and abuse investigations across referrals,... ...requires a Bachelor's degree and 2+ years in healthcare investigations, with opportunities to work in a remote, hybrid, or onsite setting and benefit from...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 work
$105k - $115k
...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support the DVA VHA in establishing and operating a high-visibility... ...annually , depending on experience and qualifications. Remote work arrangement with on-site requirements as needed....Remote workFor contractorsWork at office- ...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
- ...Humana Inc. seeks a Fraud and Waste Professional to conduct comprehensive investigations of reported or suspected fraud within Medicaid... .... The position is fully remote in the contiguous US, with... ...Bachelor's degree and 2+ years in healthcare fraud investigations, plus...Remote work
$77.1k - $92.52k
...Status: Regular Full-Time Office: Remote Salary: $77,099.34 - $92,5... ...The challenges of affordable healthcare continue to create new opportunities.... ...Responsibilities: The SIU Fraud Investigator is responsible for identifying, investigating...Remote workFull timePart timeWork at officeFlexible hours$105k - $115k
...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support a Government Consulting company supporting the Department of... ...of Integrity and Compliance (OIC). This position is 100% remote and focused on healthcare fraud lead development, case analysis...Remote workWork at officeLocal area$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$56.2k - $101k
...in Florida are highly preferred. Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing,... ...plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay...Remote jobFull timePart timeWork at officeFlexible hours$21.96 - $31.01 per hour
...Responsibilities As our Virtual Cardiopulmonary Technician II, you will perform remote cardiopulmonary rhythm surveillance for higher-acuity... ...Minimum 2 years of recent (within the past year) related healthcare work experience that would demonstrate attainment of the...Remote workWork experience placementImmediate startWork from homeShift work- ...Fraud Specialist IIIt's fun to work in a company where people truly BELIEVE in what they... ...business.Position SummaryThe Fraud Specialist II is responsible for monitoring and... ...dollar amount cases and/or moderately complex investigations with in-depth evidence gathering and...
$79.5k - $158.5k
...Impact as a Clinical Research Associate II at Worldwide As a Clinical Research Associate... ...of clinical research by partnering with investigative sites and study teams throughout the... ..., and researchers who want to make healthcare better. We were founded on an unwavering...Remote workHourly payWork from homeWorldwide$85k - $120k
...possible. The Clinical Sales Specialist II is responsible for supporting Masimo products... ...Clinical Sales Team and will be working remotely to cover Manhattan/Bronx, NY. In this... ...have the opportunity to: · Consults with healthcare partners and skilled clinicians to identify...Remote workWork from homeFlexible hoursNight shift$80.06k - $106.06k
...Special Investigations Unit Investigator II (Healthcare) The SIU Investigator II is responsible for investigating and analyzing suspected cases of fraud, waste, and abuse within the healthcare environment. This role conducts comprehensive investigations, leveraging data...Work experience placementWork from homeMonday to Friday- ...Job Description Benefit highlights: 11 Paid Holidays, 15+ days of PTO, 401k Matching, Health Benefits, and more! The Fraud Investigator II will have minimal supervision under manager or designee, accumulates information regarding initial stages of external...Work at officeLocal area
- Facilitate and communicate fraud-related requests from FinTech partners and internal departments. Perform daily monitoring reviews, track fraud events, and escalate concerns to management. Maintain accurate, audit-ready records within the GRC system and support AI initiatives...Remote job
- ...DescriptionThe Clinical Research Coordinator II handles administrative activities... ...must be tracked and monitored through Emory Healthcare under the credentialing category of Clinical... ...-person at an Emory University location. Remote work from home day options may be granted...Remote workWork from home
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