Medicare Fraud & Medical Review Analyst (Remote)
Peraton
New York, NY
- Remote job
Peraton is seeking a skilled health‑care data analyst to perform medical record reviews and apply clinical judgment to claim payments. You will research claims data, identify patterns of fraud, and develop cases for potential enforcement in coordination with external agencies. The role requires nursing or clinician experience, strong investigative abilities, and U.S. citizenship. Telework is available from the contiguous United States, with comprehensive benefits and a competitive salary range. #J-18808-Ljbffr Peraton
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Medicare Fraud & Medical Review Analyst (Remote) in New York, NY vacancy
- Peraton is seeking a Medical Review Analyst for SafeGuard Services. You will conduct medical record... ...determine claim payments, supporting fraud detection and investigations. Responsibilities... ...regulations, identifying improper Medicare payments, and developing cases for...Remote jobMedicalFraud
- Peraton SafeGuard Services seeks a Medical Reviewer to support Medicare fraud detection and payment determinations. The role focuses on reviewing medical records and applying clinical judgment to decisions on coverage and medical necessity. The position involves research...Remote workMedicalFraud
$66k - $106k
...analysis, investigation, and medical review to detect, prevent, deter, reduce... ...make referrals to recover fraud, waste, and abuse. We... ...looking to add a Medical Review Analyst to our SGS team of talented... ...to uncover problems in Medicare payments made to institutional...Remote workMedicalFraudFull timeContract workTemporary workShift workNight shift$66k - $106k
Medical Review Analyst - Medicare Job Locations US Job Information Requisition ID: 2026-170570 Position Category: Business Controls Clearance: No Clearance... ..., prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add a Medical...Remote workMedicalFraudContract workShift workNight shift$70k - $77k
Overview Medicaid/Medicare Program Integrity Analyst II - REMOTE The Medicaid/Medicare Program... ...allegations of potential fraud. Recommends and/or implements... ...Conduct independent reviews resulting from the discovery... ...with requests for medical record requests or suspension...Remote workMedicalFraudFull timeFor contractorsH2bH1bWork at officeLocal areaHome office$112.84k - $143.75k
.... Healthcare Data Analyst at GDIT. Your work... ...support the Centers for Medicare & Medicaid... ...detect and prevent fraud, waste, or abuse across... ...Options: Remote Work Location:... ...includes a variety of medical plan options, some... ...available. We regularly review our Total Rewards...Remote workMedicalFraudTemporary workImmediate startWorldwideFlexible hoursGeneral Dynamics Information Technology
Laurel, MD5 days ago- Peraton is seeking a Medical Review Nurse- Medicare to perform medical record reviews and apply clinical judgment to determine payment decisions. The role supports fraud detection and may involve research on regulations and potential referrals to law enforcement. Telework...Remote jobMedicalFraud
- Peraton seeks a Nurse Reviewer for SafeGuard Services to conduct medical record reviews and make informed payment decisions. You will support fraud investigations, identify issues, and refer cases for administrative action. Remote work is available from anywhere in the...Remote workMedicalFraud
- Peraton, a leader in national security solutions, seeks a Medical Review Nurse for Medicare fraud detection and medical claim evaluation. You will... ...violations, with the opportunity to support investigations remotely from anywhere in the United States. The role requires a...Remote jobMedicalFraud
$60k - $90k
...parties and regulatory bodies Review communications blocked by... ...external auditors For all virtual remote positions, in order to ensure... ...may include: 401(k) match, Medical, Dental, Vision, Paid-Time-Off... .... Be aware of employment fraud. All email communications from...Remote workMedicalFraudSecond jobFlexible hoursAscensus
Newton, MA17 hours ago$93.66k - $110k
...a Global Compensation Analyst working on the Human Resources... ...hoc job action, salary review and other HR process... ...(GRP). Location: Remote GDIT IS YOUR PLACE... ...includes a variety of medical plan options, some with... ...protect against identity fraud. You are expected to be...Remote workMedicalFraudTemporary workImmediate startWork from homeWorldwideFlexible hoursGeneral Dynamics Information Technology
Defuniak Springs, FL1 day ago$45.87k - $73.39k
...Summary The Collections Analyst II manages an accounts... ...balances. ~ Reviews aging receivables to... ...deadlines independently in a remote or hybrid setting.... ...experience with credit, fraud, and bankruptcy... ...Comprehensive coverage including medical (plus free telehealth),...Remote workMedicalFraudFull timeWork at officeIGS Energy Inc
United States2 days ago$89.25k - $120.75k
...depends on a Configuration Analyst joining our team to... ...Telecommuting Options: Remote Work Location: Any... ...includes a variety of medical plan options, some with... .... We regularly review our Total Rewards package... ...protect against identity fraud. You are expected to be...Remote workMedicalFraudFull timeTemporary workWork at officeImmediate startWork from homeWorldwideFlexible hours$93k - $139.8k
...mentor to Compensation Analyst I and II team members;... ...shadowing, and quality control review of junior staff work... ...an employee centric remote-first model that... ...benefits plan including medical, dental, life, vision,... ...payscale.com for support. Fraud Alert: Payscale values...Remote workMedicalFraudFull timeCurrently hiringLocal areaImmediate startWork from homeHome officeFlexible hours$84.6k - $211.6k
...Business Systems Analyst Provides expertise and systems support... ...client working sessions, design reviews, and status meetings, providing... ...of innovative medical treatments to help improve patient... ...tolerance policy for candidate fraud. All information and credentials...Remote workMedicalFraudFull timePart timeImmediate startWorldwideAvery Healthcare Group Ltd.
United States4 days ago- ...People Data Analyst Anywhere Type: Contract... ...Technology Workplace Type: Remote Standard Hours:... ...package that includes Medical, Dental, and Vision benefits... ...to, assistance in reviewing application materials to... ...activity, please contact fraud@eliassen.com ....Remote workMedicalFraudHourly payContract workLocal area
Eliassen Group
Pierre, SD16 hours ago - ...Locations and Details Location: Remote | Must reside in Austin, TX area Facility: Cedar Park Medical Center Department: Trauma... ...reconciliation protocols to review complex information sets for... ...Your Rights (Spanish) poster. Fraud prevention notice...Remote workMedicalFraudFull timeLocal areaMonday to Friday
Ascension
Cedar Park, TX4 days ago - Seeking Registered Nurse for fully remote role to perform complex medical record and claim reviews for various services and equipment (Medicare Part A and Part B) to make coverage determinations... ..., monitor for potential indicators of fraud, waste, and abuse. Provides...Remote workMedicalFraudContract workWork at officeLocal area
$60k - $70k
...Day-one coverage: medical, dental, and vision plans... ...looking for a Payments Analyst to join our high-performing... ..., CO office or a fully remote position from within... ...deficiencies following the review of account packets... ...the hiring process.** Fraud & spam screening. We use...Remote workMedicalFraudDaily paidWork at officeVisa sponsorshipWork visaFlexible hoursNight shiftAfternoon shift2 days per week1 day per weekSRS Acquiom
United States1 day ago- ...better care.? Requirements The Nurse Reviewer performs complex medical record reviews of Medicare Part A/B and DMEPOS claims that... ...potential for overpayment or fraud. Using established criteria/ and... ...essential functions. This is a remote position. While performing the duties...Remote workMedicalFraudContract workFor contractorsLocal area
- Content Solutions Analyst I (Certified Lab Coder) Job Locations US-Remote ID 2026-20145 Category Clinical... ...associated with new medical policies. In addition, this... ...will be responsible for review and analysis of current... ...inpatient, genetics, pharmacy, fraud, and dental. This role...Remote workMedicalFraudFull timeWork experience placement
$97.75k - $132.25k
...is seeking a Business Analyst to support the National... ...through design reviews, sprint activities, demonstrations... ...Telecommuting Options: Remote Work Location: USA... ...includes a variety of medical plan options, some with... ...against identity fraud. You are expected to be...Remote workMedicalFraudFull timeTemporary workImmediate startWorldwideFlexible hours$57k - $75k
...The Clinical Quality Analyst is responsible for ensuring quality medical and clinical processes are... ...Quality Analyst will also review incident reports,... .... for this position.#LI-REMOTE Our Values Connection... ...potential recruitment fraud. If you are interested in...Remote workMedicalFraudFull timeWork at officeLocal areaCharlie Health Outreach
United States1 day ago$61.79k - $98.86k
...seeking a Senior Risk Analyst - Risk Investigations,... ...outstanding balances. Review aging reports and prioritize... ...disputes, returns, and fraud controls. ~... ...Healthcare: Dental, Medical, and Vision Paid Vacation... ...Benefits #LI-Remote #LI-CA1 Please...Remote workMedicalFraudWork from homeCSG
United States2 days ago- ...LDRM is seeking Research Analysts! Come join our team of... ...LDRM we streamline the review, validation, compliance... ...on cases that involve fraud or potential criminal activity... ...from one of the most remote and harshest... ...childbirth, or related medical conditions, and would like...Remote workMedicalFraudFor contractorsWork at officeLocal areaOverseas
NANA Regional Corp
Williamsburg, KY16 hours ago $161.5k - $218.5k
...Strategic Sr. Business Analyst - Cloud Expertise GDIT... ...Options: Remote Work Location: Any... ...includes a variety of medical plan options, some with... ...available. We regularly review our Total Rewards package... ...protect against identity fraud. You are expected to be...Remote workMedicalFraudFull timeTemporary workImmediate startWorldwideFlexible hours$101k - $119k
...and are looking for a Risk Analyst to help review and approve merchant applications... ...in the development of fraud detection & risk management... ...success. ~ Comprehensive medical coverage with up to 100% employee... ...need, guilt-free. ~ Fully remote with support, including a $2...Remote workMedicalFraudFull timeWork at officeLocal areaWork from homeHome officeFlexible hoursRemote Services Inc.
San Francisco, CA1 day ago$77.6k - $176k
...254 Health Data Analyst The Opportunity... ...public sectors-from fraud detection to... ...healthcare claims data, Medicare Part A / B / C / D... ...experience with medical and pharmacy claims... ...Careers site and reviewing Our Employee Benefits... ...meetings. Remote : If this position...Remote workMedicalFraudFull timeContract workPart timeLocal area$41.6k - $45.76k
...Incident Response. About the Role Document Review Analysts will review documents for Personal... ...Incident Response. Position Details Fully remote work‑from‑home opportunity Must... ...sensitive data preferred Experience with medical billing/coding or familiarity with...Remote workMedicalTemporary workWork from homeHome officeMonday to Friday- ...Business Systems Analyst (BSA) Anywhere Type: Contract... ...Workplace Type: Remote Standard Hours: Open... ...package that includes Medical, Dental, and Vision benefits... ...meetings, portfolio reviews, planning sessions, and... ..., please contact fraud@eliassen.com . About...Remote workMedicalFraudHourly payContract workLocal area
Eliassen Group
Hartford, CT3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicare Fraud & Medical Review Analyst (Remote). Be the first to apply!
Related searches