Remote Healthcare Fraud Investigator
Integrity Management Services
Integrity Management Services, Inc. is seeking an Investigator to conduct high-level Medicare and Medicaid investigations, develop cases for further action, and coordinate with internal teams and external agencies.
The role emphasizes independent work and collaboration with managers for case development. Responsibilities include data-driven investigations, preparing detailed reports, and maintaining case files, with remote work options in the U.S.
#J-18808-Ljbffr- ...Centene Corporation is seeking an investigator to conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, and medical records to identify misconduct and support case resolution. Responsibilities include documenting investigations, preparing...Remote work
- ...To support the growth of a healthcare analytics firm, the full-time remote Healthcare Fraud Investigator will identify and qualify improper-payment leads, manage a live caseload, and drive cases to closure while collaborating with payer clients and internal teams. Key...Remote workFull time
- ...To support the DVA VHA in establishing a Fraud Rapid Response Center, the remote Senior Healthcare Fraud Investigator will lead case development by reviewing analytics-generated leads, preparing decision-ready referral packages, and collaborating with federal investigators...Remote work
- ...Job Opportunity Council Capital is a healthcare-focused private equity firm based in... ...analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid... ...but you will not manage anyone. Strong investigators here come from healthcare payer/vendor...Remote work
$105k - $115k
...Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support the DVA VHA in establishing and operating a high-visibility... ...annually , depending on experience and qualifications. Remote work arrangement with on-site requirements as needed....Remote workFor contractorsWork at office- 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 work
- ...Healthcare Fwa Investigator Levels (Investigator, Sr. Investigator, etc) will depend on experience and... ...and prevention of healthcare fraud, waste and abuse (FWA). We are growing... ...Ability to work independently within a remote team, under minimal supervision Benefits...Remote work
$79.56k - $115.72k
...an exciting place to be within the healthcare industry. As a member of Mass General... ...Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving... ...generally 8:30-5:00 PM Eastern Time Remote workspace requirements, including...Remote workFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work$77.1k
...Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare... ...Forgiveness Program (PSLF) Responsibilities The SIU Fraud Investigator is responsible for identifying, investigating, and resolving...Remote workFull timePart timeWork at officeFlexible hours- SafeGuard Services, a subsidiary of Peraton, is seeking a Fraud Investigator to perform high-level investigations of medical professional service providers. You will develop cases for future action, coordinate with state and federal partners, and prepare investigative...Remote job
- UnitedHealth Group is seeking a Coding Consultant to investigate healthcare fraud and abuse, reviewing CPT codes, medical records, and related documentation. The role supports internal and external stakeholders and provides guidance on CPT coding during investigations....Remote job
- 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 job
- A leading live shopping platform is seeking a Fraud Agent to investigate and develop solutions to mitigate fraud. This role requires identifying fraud patterns proactively and working collaboratively with the team to enhance user experience. Candidates should have experience...Remote workWork at officeWork from home
- ...Clinical Fraud Investigator II Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and... ...claims and medical records prior to payment. Researches new healthcare related questions as necessary to aid in investigations....Temporary workWork at officeLocal area2 days per week1 day per week
- ...Highmark Inc. is seeking an experienced anti-fraud investigator to develop and maintain an anti-fraud program, conduct investigations, and... ...requirements. The position requires 3 years in health insurance or healthcare fraud investigations, with preferred advanced certifications...
- ...Healthcare Fraud Investigator CGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Oxford, MS. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently...For contractorsInterim roleLocal areaFlexible hours
- ...Highmark Inc. seeks an experienced anti-fraud investigator to develop and maintain an enterprise fraud program, deliver training, and file fraud plans and reports. You will conduct investigations into fraud, waste and abuse across providers, members, facilities, pharmacies...
- ...Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete...Full timeWork experience placementWork at officeLocal area
- ...CareSource is seeking a Special Investigations Unit (SIU) III to lead high-complexity investigations into healthcare fraud, waste and abuse. This role requires strong data analysis, interviewing, and reporting capabilities and will coordinate audits and regulatory communications...
- ...Conducting comprehensive fraud, waste, and abuse investigations, the full-time SIU Investigator will analyze... ...stakeholders to support case resolution in a remote setting. Key responsibilities... ...in Business, Criminal Justice, Healthcare, or a related field, or equivalent...Remote workFull time
- ...Independently leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator... ...and support corrective actions in a remote work environment. Key... ...Degree in Business, Criminal Justice, Healthcare Administration, Public Health, or a...Remote workFull time
- ...Senior Fraud Investigator Ascensus is the leading independent technology and service platform powering savings plans across America, providing... ...and relevant experience preferred For all virtual remote positions, in order to ensure associates can effectively perform...Remote work
$29.37 - $41.12 per hour
Fraud Investigator IISalal Credit Union is seeking a Fraud Investigator II to play a vital role in safeguarding our members and organization... ...shape stronger policies and controls to reduce risk.This is a remote position, offering flexibility to work from home. However, preference...Remote workHourly payLocal areaWork from home$40 - $46 per hour
...Position Title: Fraud Investigator Location: Glen Allen, VA - Hybrid (Tuesday-Thursday onsite; Monday & Friday remote) Clearance Requirements: None Position Status: 6-Month Contract to Hire Pay Rate: $40-$46+/hr D.O.E. Position Description: Our...Remote workContract workFor contractorsMonday to Friday- A financial institution is seeking a Fraud Investigator II to safeguard members from financial crime. This remote position requires strong analytical and investigative skills. Candidates should have over three years of banking experience and two years in fraud or financial...Remote work
$37.45 - $57.29 per hour
...their hire date. Basic Life Support Certification (BLS) for healthcare providers. Preferred Qualifications ~ Bachelor's degree... ...applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related...Remote workHourly payFull timeRelocation packageShift workNight shift$89.17k - $112.94k
...interview process. About the Role: Gusto is seeking a Senior Fraud Investigations Analyst to join our Fraud Investigations team. In this role,... ..., whether you're working in-office, hybrid, or fully remote, so that you stay closely connected to your team, customers,...Remote workFull timeWork at officeLocal area2 days per week3 days per week$25 per hour
...Job Type: Contract Workplace Type: Hybrid (50% remote, 50% fieldwork) Compensation: $25/hr plus $.50/mi COMPANY... ...utilities sector. PLC's core service is outside plant damage investigation, recovery, and prevention. Across the US and parts of Canada,...Remote workContract workPart timeFor contractorsWork experience placementLocal area- ...AML/Fraud Analyst x 2 – Contract – Remote – $35.00 - $45/hr. The final salary or hourly wage, as applicable, paid to each candidate/applicant for... ...REQUIREMENTS • Expertise in financial crime analysis and investigative techniques, including identifying unusual or...Remote workHourly payContract workLocal area
- ...This position performs field investigations on disability, life, and other insurance claims. This position conducts investigative interviews... ..., and applicable policy language. This role is fully remote (within California or Dallas, TX) and requires heavy travel (7...Remote workFlexible hours
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