Remote Healthcare Fraud & Waste Investigator
Humana
Humana is seeking a Fraud and Waste Professional to investigate fraudulent and abusive healthcare practices. The role involves coordinating with law enforcement, gathering evidence, and auditing provider records to ensure accurate billing. You will prepare detailed investigative and audit reports and follow established guidelines. The position may include remote work with minimal travel and requires strong analytical and ethical standards, plus experience in healthcare payment systems and data #J-18808-Ljbffr
- ...Humana Inc. is seeking a Fraud and Waste Professional to conduct investigations of fraud and abuse and coordinate with law enforcement. You will assemble evidence... ...investigative reports to support adjudication. Remote work is available with minimal travel. Typical hours...Remote work
- Profile We offer remote work opportunities (AK, AR, AZ, CO, FL,... ...adjudicated DOD background investigation for this position. Veterans,... ...and reporting of suspected fraud, waste and abuse (FWA) cases as defined... ...Veterans Affairs (VA), the Healthcare Finance Administration (HCFA...Remote workContract workFor subcontractorInterim role
- Centene Corporation seeks a candidate to investigate allegations of potential healthcare fraud and abuse. This role involves conducting thorough investigations... ...in the field is required. The position offers a remote working option for candidates residing within Ohio and...Remote job
$56.2k - $101k
Centene Management Company LLC is seeking a Fraud Investigator to investigate allegations of healthcare fraud and abuse. The role is remote but prefers candidates from Texas. The investigator will conduct detailed claims investigations, assist with audits, and prepare reports...Remote job- A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing... ...a minimum of 5 years in fraud investigations. This is a remote role with a strong preference for residents of New York....Remote job
- Centene Management Company LLC is seeking candidates for a position dedicated to investigating allegations of healthcare fraud and abuse within the Kentucky Medicaid Program. The ideal applicant will have a Bachelor's Degree in a related field and a minimum of three years...Remote job
$56.2k - $101k
Centene Management Company LLC is looking for a skilled investigator to focus on potential healthcare fraud and abuse activities. The candidate will analyze claims, conduct investigations, and prepare detailed reports for regulatory agencies. A Bachelor's degree in Business...Remote jobFlexible hours- Centene Corporation is seeking an investigator to tackle healthcare fraud and abuse, essential for transforming health in communities. This remote role requires a bachelor's degree and at least one year of experience in medical claim investigations. You'll conduct thorough...Remote jobFlexible hours
- 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 hold...Remote jobFlexible hours
$60k - $92k
...Levels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ..., investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and looking... ...to work independently within a remote team, under minimal supervision Benefits...Remote workFull time$104k - $143k
...next steps. Our partner is looking for a Fraud, Waste & Abuse Lead Analyst based in United... ...identifying, preventing, and reducing healthcare-related financial and operational risks... ...organizational performance. ~ Fully remote work opportunity across the United States...Remote jobFull timeTemporary workWork at office- ...Job Description Job Description Fraud Investigator / Fraud Analyst / Fraud Specialist Location - Remote and Onsite Thrice a week --- Pensacola, FL / Winchester... ...Our expertise spans industries from providing healthcare information systems to developing E-Remit software...Remote workHourly payLocal areaImmediate startWorldwide
$97.53k - $141.42k
...4Job SummaryAs a member of our Compliance team, the Sr. Fraud, Waste, Abuse Investigator will help ensure CenCal Health’s compliance with applicable... ...plan’s FWA activities.Maintains current awareness of healthcare and health plan compliance laws and regulations, as well...Contract workLocal area- ...Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in... ...for litigation Analyze data for evidence of fraud, waste and abuse Review and evaluate referrals to determine the...Full timeWork experience placementWork at officeLocal area
- ...an exciting place to be within the healthcare industry. As a member of Mass General... ...at identifying potential fraudulent, wasteful, or abusive claim submissions. In... ...FunctionsResponsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving...Contract workWork at officeLocal areaFlexible hours
- CVS Health’s Meritain Health SIU is seeking an Investigator to support the Special Investigations Unit in preventing and pursuing healthcare fraud, waste, and abuse while recovering funds for self‑funded plans. This role requires strong investigative skills, collaboration...
$46.99k - $122.4k
...Enhancement is hiring for a full-time position focused on healthcare fraud investigation in South Dakota. The role requires handling complex cases... ...necessitates 3 years of experience in health care fraud, waste, and abuse audits. The ideal candidate will have strong analytical...Full timeWork at office$46.99k - $122.4k
...Alliance for Career Enhancement is hiring for a position focused on investigating healthcare fraud cases. The ideal candidate will have a Bachelor’s degree and at least 3 years of experience in fraud, waste, and abuse investigations. Responsibilities include handling...Full time- The Hispanic Alliance for Career Enhancement is looking for an investigator focused on health care fraud, waste, and abuse. This role requires expertise in managing complex cases and collaborating with clinical and legal teams. As an integral part of our organization,...
- ...hope. Overview Responsible for complex fraud and abuse investigations and data analysis to identify trends,... ...multiple perpetrators or intricate healthcare fraud schemes. Investigate fraud and... ...validity of allegations of fraud waste and abuse. May include conversations...Local area
- PacificSource is seeking a Senior Investigator - Fraud, Waste, and Abuse to plan, conduct, and manage investigations of health care claims, documenting... .... The role requires at least 4 years of experience in healthcare fraud investigations, use of OSINT tools, and...
$46.99k - $122.4k
...insured commercial health plans. The SIU Investigator will support Meritain Health’s Network... ..., investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to... ...years of experience working in fraud, waste and abuse investigations and audits. 3...Hourly payFull timeTemporary workWork experience placementWork at officeLocal areaFlexible hours$46.99k - $122.4k
The Hispanic Alliance for Career Enhancement is seeking a dedicated professional to handle investigations into healthcare fraud, waste, and abuse, focusing on complex cases and cooperation with law enforcement. This full-time position requires a bachelor's degree, with...Full time$3,000 - $4,999 per month
...available (1) - b. $3000 - $4999 per month Functional Title: Claims Investigator Job Title: Investigator II Agency: Health & Human Services... ...III is responsible for investigating referrals of fraud, waste, and abuse by HHS clients; conducting thorough research and evidence...Remote workFull timeTemporary workPart timeWork at officeShift work$31.25 - $35 per hour
...Job Description Medicaid Fraud Investigator – Special Investigations Unit (SIU) Location: [Remote - ideally in the Chicago area... ...some of the brightest minds in healthcare. Surround yourself with talented... ...eliminate healthcare fraud, waste, and abuse (FWA). As an SIU...Remote workHourly payPermanent employmentFull timeContract workTemporary workWork experience placementShift work$56.2k - $101k
...Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing... ...investigations of potential waste, abuse, and fraud. Document activity... ...holidays Flexible approach to work with remote, hybrid, field, or office...Remote workWork at officeFlexible hours$46.99k - $122.4k
...The Hispanic Alliance for Career Enhancement is seeking a dedicated investigator for healthcare fraud cases based in Missouri, Louisiana. The role requires extensive knowledge of healthcare fraud prevention and the ability to interact effectively with various stakeholders...$28.49 per hour
...Medicolegal (Medical) Death Investigator I, II, or III Location... ...026-3859 Category Healthcare, Welfare, and Social Services... ...- Regular (Full Benefits) Remote No Post End Date... ...disposition of biohazardous materials/waste, property, evidence,...Remote workFull timeWork at officeLocal areaShift workNight shiftAfternoon shift- ...At UK King's Daughters, we're not just a healthcare facility - we're a family of dedicated... ...incident reports in security systems. • Investigates incidents and reports unusual... ...Hazardous chemicals and fumes including waste: 2. Occasional ( O. Radiation: 1. Never...Remote workHourly payFull timePart timeReliefInternshipShift work
- ...To enhance customer security, the full-time Fraud Investigator will focus on investigating account takeover (ATO) incidents and third-party fraud, managing high-risk cases remotely while providing empathetic support to customers during critical recovery events. Key responsibilities...Remote workFull time
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