Remote Medicaid Fraud & Investigations Specialist
Pplfirst
- Remote job
Public Partnerships LLC is seeking a Fraud Audit & Investigations Analyst to lead investigations into fraud, waste, and abuse within Medicaid programs. You will audit case files, prepare regulator-ready materials, and coordinate responses to RFIs from OMIG, MFCUs, and health plans. Ideal candidates have 5–7 years across LHCSA, MCO/health plan, or state regulatory Medicaid roles, with strong documentation skills and ability to work remotely with occasional travel. #J-18808-Ljbffr Pplfirst
$90.58k - $114.59k
...InformationNY HELPS: No55-b/c Eligible: NoAgency: Medicaid Inspector General, NYS Office of the Title: Investigative Specialist 2 MedicaidOccupational Category: No... ...investigations of providers alleged of committing fraud, waste, and abuse. The official workstation of...Remote workFraudPermanent employmentFull timeWork experience placementInternshipWork at officeVisa sponsorship- The Agency for Health Care Administration seeks an Inspector Specialist to conduct investigations into fraud, abuse, and waste within the Florida Medicaid program. You will perform on-site visits, prepare investigative reports, and collaborate with multiple units to enforce...Fraud
- ...Fraud Investigations Specialist We are seeking a detail-oriented and experienced Fraud Investigations Specialist to join a premier financial services... ...on a hybrid schedule: Tuesday, Wednesday, and Thursday in office, Monday and Friday remote, plus a Saturday rotation....Remote workFraudWork at officeMonday to Friday
- ...Knowledge of internal audit/investigative policies and operating principles... .... Understanding of Medicare/Medicaid or healthcare auditing.... ...and make referrals to recover fraud, waste, and abuse. We are looking... ...business acumen. This is a remote position. #J-18808-Ljbffr PeratonRemote workFraudWork at office
$28 - $38 per hour
We are seeking a detail-oriented and experienced Fraud Investigations Specialist to join a premier financial services organization. In this role,... ...Tuesday, Wednesday, and Thursday in office, Monday and Friday remote, plus a Saturday rotation. Key Responsibilities...Remote workFraudHourly payPermanent employmentTemporary workWork experience placementWork at officeMonday to FridayShift workWeekend work$43.27k - $50k
## Investigative SpecialistApply: Wake County, NC: Full time: Posted Today... ..., along with investigating fraud matters involving insurance consumers... ...routine office and up to one remote workday per week. The NC... ...purpose of the Investigative Specialist is to provide comprehensive...Remote workFraudFull timeContract workFor contractorsWork experience placementWork at officeFlexible hoursNight shift$20.5 - $27 per hour
...search of an Asset Protection Specialist to be part of our Asset... ...Protection Burlington Response and Investigation Center (BRIC) Team! This is... ...and investigate theft, fraud activity, and persons of interest... .... Leverage CCTV systems to remotely audit third party guard...Remote workFraudHourly payFull timeImmediate startFlexible hoursNight shiftWeekend workAfternoon shift- ...ELIGIBILITY SPECIALIST I - 60055865 Families in need and in crisis... ...for Food Assistance, Medicaid, and Cash Assistance. Learning... ...cases where identity theft or fraud is suspected. Advising... ..., interviewing, recruiting, investigating, accounting, processing insurance...Remote workFraudFlexible hours
- Healthcare Fraud Shield is seeking a CPC-certified Medical Coding Specialist to join our SIU team. You will review medical records, abstract CPT/HCPCS/Revenue Codes... ...and provide subject matter expertise for clients. Remote work eligible; 401(k), generous PTO, and...Remote jobFraud
- ...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 workFraud
- ...Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention... ...and abuse, while working remotely. Key responsibilities Conducts... ...of managed care, Medicaid, Medicare, and claim billing...Remote workFraudFull time
- ...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 workFraud
- ...Independently leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator... ...and support corrective actions in a remote work environment. Key... ...healthcare regulations, including Medicaid and Medicare Preferred certifications...Remote workFraudFull time
$88k - $176k
...per week in the office. Remote working requests will... ...I Program Integrity Specialist you will play a vital... ...which are primarily state Medicaid andChildrens Health... ...projects related to fraud waste and abuse prevention... ...Healthcare Fraud Investigator (AHFI) or equivalent...Remote workFraudMinimum wageFull timeFor subcontractorWork at officeLocal areaFlexible hours3 days per week1 day per week- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will... ...and prevention of healthcare fraud, waste and abuse (FWA). We... ...multiple clients with Medicaid, Medicare, Federal Employee and... ...work independently within a remote team, under minimal supervisionBenefits...Remote workFraud
- California Department of Justice's Division of Medi-Cal Fraud and Elder Abuse is seeking a Medicaid Fraud Attorney - Civil Litigation to lead investigations of complex healthcare fraud and litigate in state and federal courts. Attorneys manage their own caseloads, collaborate...Remote jobFraudWork at office1 day per week
- ...platform pairs analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid, Commercial, and FEP lines of business, returning... ...success, but you will not manage anyone. Strong investigators here come from healthcare payer/vendor backgrounds...Remote workFraud
$75k - $90k
...Maintenance Procedure Card (MPC) Specialist- ELEX to develop MPCs to... ...be subject to a security investigation and may need to meet eligibility... ...that happens in person or remotely. If the position is remote... ...your identity and prevent fraud. If you require reasonable...Remote workFraudWork at officeLocal area$115k
...Solutions is seeking a Senior Healthcare Fraud Investigator to support a mission focused on... ...oversight initiatives. This position is remote and candidates must be local to Washington... ...program integrity, Medicare, Medicaid, or healthcare fraud case development efforts...Remote workFraudFor contractorsLocal area$70k - $80k
MEDICAID ELIGIBILITY VERIFICATION SPECIALIST Full-time Agency: HRA/DEPT OF SOCIAL SERVICES Job Category: Administration... ...disallowances and minimizing fraud. Verify clients’ demographics and... .... Prepare reports of referrals to Investigation, Revenue and Enforcement...FraudPermanent employmentFull timeWork at office$24 - $46.81 per hour
...JOB DESCRIPTION Job Summary Provides investigative support for special investigation unit (... ...recovery of money related to health care fraud, waste, and abuse (FWA). Responsible for... .... • Actively participates in Medicaid Fraud Control Unit (MFCU) meetings and roundtables...Remote workFraudHourly payContract workWork experience placementWork at officeLocal area$105k - $115k
...Solutions is seeking a Senior Healthcare Fraud Investigator to support the DVA VHA in establishing... ..., including experience with Medicare, Medicaid, VHA healthcare fraud referrals, or... ...depending on experience and qualifications. Remote work arrangement with on-site...Remote workFraudFor contractorsWork at office$45.5 per hour
...16th to Feb 8th might extend Fraud Waste Abuse exp Commercial Medicare/ Medicaid on site Bowie MD 3 days a week... ...data science teams to translate investigative judgment into refined detection... ...personal information. xhyhwjd Remote working/work at home options are...Remote workFraudWork from home3 days per week- ...Summary of the Position: The Compliance Investigator is responsible for conducting objective, thorough... ...experience is preferred Knowledge of HIPAA, Medicare, Medicaid, Behavioral Health Licensing requirements, and fraud prevention is a plus. Valid driver's license...Remote workFraudHourly payWeekly payFull timeTemporary work
$20k
BSA/AML Specialist x 2 -Contract - Remote- $28.00 - $32.0/hr.Apply promptly! A high volume of applicants is expected... ...internal compliance referralsExperience investigating cash transactionsPrevious financial crimes, AML, fraud, or compliance operations experienceBanking...Remote workFraudHourly payContract workLocal areaWork from homeVisa sponsorship$77.6k - $176k
...selected will be subject to a security investigation and may need to meet eligibility requirements... ...and protect against identity fraud. You are expected to be on camera during... ...to have their cameras on during meetings.Remote: If this position is listed as remote, there...Remote workFraudFull timeContract workPart timeWork at officeLocal area- ...Debit Card Dispute Resolution Specialist $25-$27/HR W2 Duration:... ...in Pensacola, FL / 2 Days Remote "Work sponsorship is not... ...and loss prevention risk and fraud insurance. Work under direct... ...Complete basic routine account investigations and respond to actions...Remote workFraudContract workLocal area3 days per week
$62k - $141k
...As an Intelligence Management Specialist, you use your specialized... ...will be subject to a security investigation and may need to meet eligibility... ...and protect against identity fraud. You are expected to be on... ...their cameras on during meetings.Remote: If this position is listed...Remote workFraudFull timeContract workPart timeWork at officeLocal area- ...oriented entry-level Chargeback Specialist to join our growing team. In... .... This is a hybrid position (remote/in-office) reporting to the... ...maintaining accurate financial records.Fraud Monitoring Support: Assist in... ...Mindset: A proven ability to investigate information and formulate...Remote workFraudWork at office
- ...Key is seeking an Account Resolution Specialist to independently manage dispute and fraud cases on past-due accounts. You will own investigations, bank-compliant logging, and timely resolutions... ...team. This position offers a remote work option within the United States,...Remote workFraud
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