Remote Healthcare Fraud & Abuse Investigator (CPC/CFE)
Sentara Health
Sentara Health Plans in the United States is hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) for a remote role. The position is full-time (40 hours) with occasional travel to Virginia Beach. You will contribute to deep investigations of fraud across provider, pharmacy, and claims, review coding quality, and help ensure accurate reimbursement. Remote work is available for qualified US candidates, with annual travel to Virginia Beach.
#J-18808-Ljbffr- Sentara Health Plans is seeking an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) for a remote role. The position supports in-depth... ...combined experience in medical coding or healthcare, plus a CFE or AHFI certification. #J-18808-Ljbffr Sentara...Remote job
$32.03 - $45.7 per hour
...currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time, permanent... ...required in Medical Coding OR Healthcare (Medical Chart Review/Insurance... ...Certified Fraud Examiner (CFE) OR Accredited Health Care Fraud...Remote jobHourly payPermanent employmentFull timeTemporary workLive inCurrently hiringShift work- Sentara Health Plan is hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) for a remote role. The position is full-time (40 hours) with shifts 8am-5pm EST, M-F, and remote for multiple states including MD, VA, NC and others, with annual...Remote jobFull timeShift work
- Sentara Health Plans is hiring for an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) in a remote role. The position offers full-time status with 40 hours weekly, primarily 8am-5pm EST, Monday-Friday. Remote work is available for multiple states...Remote jobFull timeMonday to Friday
$65k - $88.6k
...community The Fraud and Waste Professional... ...comprehensive investigations of reported,... ...Responsibilities Analyze healthcare payment... ...fraud, waste, and abuse involving the Medicaid... ...Certifications, CPC, CCS, CFE, AHFI).... ...Work Style Fully remote in the contiguous...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$65.97k - $124.99k
A healthcare services provider is seeking a Clinical Fraud Investigator II, requiring an Associate Degree in Nursing and CPC certification. Responsibilities include analyzing clinical data, investigating... ...investigation. This role offers remote work flexibility within certain...Remote work- ...Senior Healthcare Fraud InvestigatorArlo Solutions is supporting... ...personnel.Location: REMOTE - Local to Washington,... ...fraud, waste and abuse (FWA) and coordinated... ...taxonomy, and standard investigation templates.Overpayment... ...Certified Fraud Examiner (CFE) certificationCurrent...Remote workContract workFor contractorsWork at officeLocal area
- ...Molina Healthcare in Iowa Center seeks an Investigative Support Specialist for its Special Investigation Unit (SIU). You will support prevention,... ...detection, investigation, and reporting of health care fraud, waste, and abuse (FWA) and ensure coding accuracy according to...
- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ...and prevention of healthcare fraud, waste and abuse (FWA). We are growing and... ...to work independently within a remote team, under minimal supervisionBenefits...Remote work
- ...Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention, detection, and investigation... ...of healthcare fraud, waste, and abuse, while working remotely. Key responsibilities Conducts...Remote workFull time
- ...Investigating suspected fraud and financial crimes impacting the Auto Finance business, the full-time remote Fraud Investigator - CFE Required will develop investigative plans, gather evidence, and prepare reports while collaborating with various departments to mitigate...Remote workFull time
$69.4k - $99.2k
...Summary The Medicaid Fraud, Waste & Abuse (FWA) Senior Analyst plays... ...questions, and supporting investigations through data analysis,... ...activities (Up to 25%) Fully remote opportunity with the option... ...who care deeply about making healthcare work better for everyone. Build...Remote workFull timeWork at officeFlexible hours$55.6k - $79.4k
...~3+ years of experience detecting and investigating healthcare fraud ~2+ years providing excellent customer... ...Certified Fraud Examiner (CFE) Experience with Medicaid Management... ...should expect in this role Fully remote opportunity with the option to work anywhere...Remote workFull timeFlexible hours- ...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
- ...Humana, Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported or suspected fraud related to Medicaid programs. The role... ...provider records to ensure billing integrity. Fully remote in the contiguous US with periodic travel...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
$77.5k - $99k
...by states and managed healthcare organizations to better... ...The Program Integrity Fraud Audit & Investigations Analyst conducts fraud, waste, and abuse (FWA) investigations... ...preferred Certification: CFE, AHFI, or CCEP... ...Working Conditions: Remote work with occasional...Remote workLocal area- ...payment decisions, and researching claims data to uncover fraud, waste, and abuse.Telework is available from anywhere in the United States.... ...will review Medicare payments, develop cases for investigations, and collaborate with external agencies as needed.J-18808...Remote work
- ...support the DDVA VHA program in establishing and operating a high-visibility Fraud Rapid Response Center through a 100% remote work arrangement. The role focuses on detecting and responding to healthcare FWA while safeguarding taxpayer dollars. The Analyst will develop...Remote work
- Humana Inc. is seeking a Fraud and Waste Professional to conduct investigations of reported, alleged or suspected fraud involving Medicaid programs. You will coordinate... ...complex investigative and audit reports. This remote role uses data analysis to detect irregularities,...Remote job
- ...Hartford in Scottsdale, AZ is seeking a Sr Medical Bill Examiner (CPC) to review complex medical invoices for workers’ compensation.... ...to accuracy and regulatory compliance. This role offers a hybrid/remote arrangement with core hours across time zones, strong data-entry...Remote job
- ...Laitinen Academy seeks a Clinical Instructor to deliver comprehensive training in Substance Abuse Counselor in Training (SAC-IT), Substance Abuse Counselor (SAC), and healthcare elective courses. This role blends clinical expertise with educational skill and will average...Remote workWork from homeFlexible hours
- ...To manage comprehensive fraud, waste, and abuse investigations, the full-time remote CPC Certified Senior SIU Investigator will develop investigative strategies... ...of experience in fraud investigations or related healthcare insurance roles Bachelor's degree or a combination...Remote workFull timeWork experience placement
- ...Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking aHealthcare Fraud Investigator... ...litigation. Analyze data for evidence of fraud, waste and abuse. Review and evaluate referrals to determine the need for additional...Full timeWork experience placementWork at officeLocal area
- ...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...
- ...Highmark Inc. seeks an experienced anti-fraud investigator to develop and maintain an enterprise fraud program, deliver training, and file fraud... .... You will conduct investigations into fraud, waste and abuse across providers, members, facilities, pharmacies, groups, and...
$80.06k - $106.06k
...Special Investigations Unit Investigator II (Healthcare) The SIU Investigator II is responsible for... ...analyzing suspected cases of fraud, waste, and abuse within the healthcare... ...Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), or similar certification...Work experience placementWork from homeMonday to Friday- TEKsystems is seeking a remote fraud analyst to join an operations team focused on payments fraud, protecting Meta users and partners... ...tickets while applying a diverse toolkit of data analysis and investigative work. The role requires 3+ years in fraud investigations or...Remote job
- ...tomorrow.Section 1: Position SummaryThe Senior Fraud Investigator is a senior individual contributor... ...enhancementsCertifications such as CFE, CAMS, or CFCS are a plusBachelor’s degree... ...relevant experience preferredFor all virtual remote positions, in order to ensure associates...Remote workFull timeSecond job
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