Medicaid Fraud & Waste Investigator - Remote SC
Humana
- Remote job
Humana is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported, alleged, or suspected fraud involving South Carolina's Medicaid program. This role partners with law enforcement and internal teams to assemble evidence and prepare investigative reports. Fully remote in South Carolina with occasional travel to Humana offices for training. The position requires a Bachelor's degree, 2+ years of healthcare fraud investigations, and strong analytical and #J-18808-Ljbffr Humana
- Humana seeks a Fraud and Waste Professional in South Carolina to lead investigations of fraud, waste, and abuse in the Medicaid program. You will gather evidence, perform on-site audits of provider records, and prepare detailed investigative summaries for leadership and...Remote job
- Humana, Inc. is seeking a Fraud and Waste Professional to lead investigations of suspected fraud within South Carolina's Medicaid program. You will coordinate with law enforcement... ...integrity and protect members. Remote work is possible in SC with occasional travel. #J-18808-...Remote job
$65k - $88.6k
...of our caring communityThe Fraud and Waste Professional is responsible... ...for conducting comprehensive investigations of reported, alleged or... ...involving South Carolina's Medicaid Program. The Fraud and Waste... ...Waste Work Style Fully remote in South Carolina , with...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- Humana is seeking a Fraud and Waste Professional to conduct comprehensive investigations into fraud related to Medicaid programs. The role coordinates with law enforcement, assembles evidence, and performs on-site audits of provider records to ensure billing integrity....Remote job
$32.03 - $45.7 per hour
...currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time,... ..., NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA,... ...of potential fraud, waste, and abuse. -... ...serving Medicare and Medicaid enrollees. Our quality...Remote workHourly payPermanent employmentFull timeTemporary workLive inCurrently hiringWork at officeShift work$86k - $138k
...subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent,... ...reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add... ...between the SE UPIC, HHS OIG, State Medicaid Agencies (SMA), and the Department of...Remote workFull timeContract workTemporary workFor contractorsWork at officeShift workNight shift- ...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 work
- ...Healthcare Fwa Investigator Levels (Investigator, Sr. Investigator... ...and prevention of healthcare fraud, waste and abuse (FWA). We are... ...Support multiple clients with Medicaid, Medicare, Federal Employee... ...work independently within a remote team, under minimal supervision...Remote work
$51k - $82k
...subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent,... ...reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add a... ...~ Knowledge of Medicare and/or Medicaid programs and the rules, regulations, policies...Remote workContract workTemporary workFor contractorsFlexible hoursShift workNight shift$77.1k - $92.52k
...Regular Full-Time Office: Remote Salary: $77,099.... ...HomeFirst, our Medicare and Medicaid managed care health plans,... ...: The SIU Fraud Investigator is responsible for identifying... ...allegations and indicators of fraud, waste, and abuse (FWA) involving...Remote workFull timePart timeWork at officeFlexible hours- ...Inspector General (OIG) - Career Brochure To conduct investigations of fraud, waste or abuse by recipients, non-Medicaid providers and vendors of all MDHHS administered... ...be notified of the results. Position Location/Remote Office The physical location of this position is...Remote workFull timeWork at office
- ...Centene Corporation is seeking an SIU Investigator in the United States to conduct fraud, waste, and abuse investigations using referrals, claims data, medical records, and interviews. You will prepare reports, coordinate with internal teams, and support program integrity...Remote work
- ...reside across the U.S. — with a variety of remote, hybrid and in‑person roles. We enjoy... ...NH NC ND OH OK PA SC SD TN TX UT WV WI WY... ...full potential Responsibilities The Fraud Investigator II role is focused on independently managing...Remote workFull timeWork experience placementWork at officeLocal areaWork from home
$65.6k - $98.4k
...flexible work arrangements that include remote and hybrid opportunities and paid... ...of potential provider or member fraud and abuse cases. Conduct the investigation of fraudulent and abusive... ...emerging issues in healthcare fraud, waste, and abuse. Conduct audits and interviews...Remote workContract workWork at officeLocal areaWork from homeFlexible hours2 days per week1 day per week- ...Centene Corporation is seeking an investigator to conduct fraud, waste, and abuse investigations across referrals, claims data, and medical records.... ...healthcare investigations, with opportunities to work in a remote, hybrid, or onsite setting and benefit from Centene's...Remote work
- ...Essential Functions Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving medical providers, plan members... ...Friday schedule, generally 8:30-5:00 PM Eastern Time. Remote workspace requirements, including privacy and security...Remote workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work
- ...Centene Corp. is hiring a SIU Investigator to conduct fraud, waste, and abuse investigations remotely in Texas. You will review referrals, claims data, medical records, and provider information to identify misconduct and support case resolution. Prepare investigative reports...Remote work
- Cotiviti is seeking an Investigator to scrutinize suspected healthcare fraud, waste, or abuse using data analysis. This is a remote, work-from-home role within the United States. Responsibilities include analyzing patterns, producing written summaries, and supporting legal...Remote jobWork from home
- Cotiviti is hiring a Senior Investigator to analyze data and investigate suspected healthcare fraud, waste, and abuse from a remote/home-based position aligned with the post-pay Fraud Waste & Abuse team. The role involves interviews, reporting findings, and may require...Remote jobCasual workWork from home
$62.4k - $71.76k
State of Florida, Office of the Attorney General, Medicaid Fraud Control Unit in Miami, seeks a Law Enforcement Investigator II to conduct investigations into Medicaid fraud and patient abuse. The role requires U.S. citizenship, a high school diploma, and successful completion...Work at office- The Oregon Department of Justice is seeking an experienced Investigator 3 to join the Medicaid Fraud Unit in the Civil Enforcement Division. This role conducts statewide investigations of Medicaid provider fraud, abuse, and financial exploitation in long-term care settings...
- The City of New York seeks a Fraud Investigator II to join the Medicaid Provider Investigation Division (MPID) within the Department of Social Services in New York City. The role includes reviewing data from the Medicaid Data Warehouse, investigating suspected Medicaid...
- The State of Georgia invites applications for the Investigator - Medicaid Fraud position within the Department of Law. The role focuses on health care fraud investigations, developing data analyses, and supporting prosecutors with evidence and testimony. Ideal candidates...Day shift
- The Medicaid Provider Investigation Division (MPID) of the NYC Department of Social Services is recruiting for Fraud Investigator II to conduct investigations of Medicaid providers and clients suspected of fraud. Responsibilities include data review, interviewing subjects...
- The Oregon Department of Justice seeks an experienced Investigator 3 for the Medicaid Fraud Unit in the Civil Enforcement Division in Portland. You will conduct statewide investigations into provider fraud, abuse, neglect, and financial exploitation in long-term care settings...
- Peraton is seeking a Medicaid Auditor/Investigator to join SafeGuard Services (SGS), a Peraton subsidiary... ...audits and data analyses to detect fraud, waste, and abuse in Medicaid programs. You... ...state requirements. The position is remote, requiring residency within the...Remote job
- The Office of the Attorney General in Florida's Medicaid Fraud Control Unit is seeking a Senior Investigator in Miami. The role involves independent investigations of Medicaid fraud and patient abuse, gathering evidence, interviewing witnesses, and preparing reports and...Work at office
- The Office of the Attorney General, Department of Law Medicaid Fraud Division in Georgia seeks an Investigator to support health care fraud investigations and patient abuse inquiries. You will review records, interview witnesses, and assist in preparing reports and exhibits...Work at office
$57.98k - $69k
...Division DOJ Legal Services Job Classification Title Financial Investigator I (NS) Position Number 60010403 Grade NC16 About Us The... ...to perform investigations in the area of criminal and civil Medicaid fraud schemes, patient abuse or neglect, and misappropriation of recipient...Local areaNight shift$3,000 - $4,999 per month
...HHS webpage . Functional Title: Claims Investigator Job Title: Investigator II Agency: Health... ...of HHS programmatic services, such as Medicaid; the Children’s Health Insurance... ...responsible for investigating referrals of fraud, waste, and abuse by HHS clients; conducting thorough...Remote workFull timeTemporary workPart timeWork at officeShift work
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