Healthcare Fraud Investigator
$85k - $105kCGS Federal (Contact Government Services)
1 day ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. CGS Federal (Contact Government Services) provided pay range This range is provided by CGS Federal (Contact Government Services). Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $85,000.00/yr - $105,000.00/yr 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 tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include: Review, sort, and analyze data using computer software programs such as Microsoft Excel Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.) Develop HCF case referrals including, but not limited to: Ensure that HCF referrals meet agency and USAO standards for litigation Analyze data for evidence of fraud, waste and abuse Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc Assist conducting witness interviews and preparing written summaries Qualifications: Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data) Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy U.S. Citizenship and ability to obtain adjudication for the requisite background investigation Experience and expertise in performing the requisite services in Section 3 Must be a US Citizen Must be able to obtain a favorably adjudicated Public Trust Clearance Preferred qualifications: Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3 Relevant experience working with a federal or state legal or law enforcement entity #CJ Seniority level Seniority level Not Applicable Employment type Employment type Full-time Job function Job function Legal Industries Transportation, Logistics, Supply Chain and Storage Referrals increase your chances of interviewing at CGS Federal (Contact Government Services) by 2x Get notified about new Fraud Investigator jobs in Austin, TX . 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$65k - $88.6k
...Become a part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The... ...Qualifications • Bachelor's degree • 2 years of healthcare fraud investigations and auditing experience • Knowledge...SuggestedFull timeTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$85k - $105k
...Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level 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...SuggestedFull timeWork experience placementWork at officeLocal area- ...The Texas Attorney General's Office is seeking Assistant Attorneys General in Austin, Texas, for the Healthcare Program Enforcement Division. The role requires a Juris Doctor degree and a minimum of two years of experience as a licensed attorney. Candidates will manage...SuggestedWork at office
- ...and make an impact.SUMMARYAs a Senior Fraud Response Analyst, you will play a key role... ...process, including incident intake, investigation support, stakeholder communications, escalation... .... And our benefits go beyond healthcare—offering resources for physical, mental...SuggestedFull timeWork experience placementWork visa
- ...awareness together.SUMMARYAs a Senior Fraud Response Data Analyst, you will transform... ..., and deliver insights that support investigations, incident response, fraud mitigation, and... ...prioritized. And our benefits go beyond healthcare—offering resources for physical, mental...SuggestedFull timeLocal areaWork visa
- Wealthfront is hiring a fully remote Fraud Operations Specialist to monitor and investigate daily fraud activity. You will work with Compliance, Engineering, and product teams to strengthen controls and automation, while conducting complex investigations across multiple...Remote job
- Wealthfront Corporation is seeking a Fraud Operations Specialist to monitor and investigate daily fraud activity in a fully remote role. You will work closely with Compliance, Engineering, and Product to optimize detection rules and controls, while maintaining adherence...Remote job
- Allied Universal Compliance and Investigations seeks candidates for the Field Site Inspector role to perform site visit inspections for Medicare and Medicaid providers. The inspector visits locations, photographs, interviews, collects data, and documents findings using...
$100k - $150k
...for a better today and tomorrow. Ascensus is seeking a Senior Fraud Strategy Analyst to join our Fraud Risk Management team. This... ...3-7 years of progressive experience in fraud strategy, fraud investigations, financial crimes, or financial services risk management Experience...- Ouro currently seeks a Senior Fraud Specialist in Austin to manage the most complex fraud investigations and prevention initiatives. You will act as a project leader, identify gaps in the fraud landscape, and contribute to development of new protective procedures. This...
- Allied Universal is hiring a Surveillance Investigator to perform discreet mobile and stationary surveillance of claimants to support insurance claim administration. The role involves independent investigations across workers’ comp, general liability, property and casualty...Work experience placementFlexible hours
- ...recognition for exceptional strides in healthcare innovation, is supported by medical societies... ...500,000 patients worldwide. The Product Investigator role is a full-time position that... ...referrals. Heartflow has become aware of a fraud where unknown entities are posing as Heartflow...Full timeWork experience placementWork at officeLocal areaWorldwideRelocation
- ...most important challenges. From advancing healthcare and scientific discovery to powering AI... ...to join its global Corporate Security Investigations team. This role reports to the Director... ...certification, such as Certified Fraud Examiner (CFE), Certified Protection Professional...Local area
- ...safeguard the Google Ads ecosystem. The role blends technical data analysis, strategic cross-functional leadership, and direct investigative work to predict threats and influence how teams build detection systems. You will partner with stakeholders to optimize performance...
- Gfoat in Texas seeks a Workers' Compensation Claims Adjuster to investigate and manage claims, ensuring accurate benefit administration while protecting pooled funds. You will assess compensability, coordinate medical treatment, prepare cases for dispute resolution, and...
- ...compassionate and professional approach, creating a positive exam experience for Veterans, guiding them through a critical step in their healthcare journey. Pay: Base + Monthly Incentive = $140,899-$206,899 a year * Please note: this position DOES NOT...For contractorsFor subcontractorWorldwide
- ...Registered Nurse) Galveston, Texas, United States Hot 1 additional location United States Nursing & Care Management HealthCare System Staffing Requisition # 2504468 Job Summary: Per diem position. Proficient Clinician. Practice is characterized...Daily paidWork at officeShift work
- Information Providers, Inc. is seeking a part-time Insurance Property Inspector in Austin, TX. This 1099 role offers flexible weekday hours and requires independent work with travel to local inspection sites. You'll perform on-site property inspections, take detailed photographs...Part timeLocal areaFlexible hoursWeekday work
- ...software, AI, computer vision, and world-class content to help people build strength and live healthier. Tonal is now expanding into healthcare and clinical applications, connecting strength training technology with providers, employers, and payers to deliver measurable...Contract workWork at officeLocal area
- ...adherence to PPGT's access control policies. • May assist with investigations and critical event responses in coordination with supervisor... ...electronic forms for purposes of treatment, payment, and/or healthcare operations. The use of a client's protected health...Permanent employmentFor contractorsWork at officeFlexible hoursAfternoon shift
- ...including organizing workload, submitting examination findings, and corresponding with the Quality Assurance Team. Collaborate with Healthcare Professionals: Coordinate and collaborate with other healthcare professionals, specialists, and experts as needed to obtain...For contractorsFor subcontractorWorldwideMonday to Friday
$15 - $20.4 per hour
...maintains confidentiality Observes, apprehends, and/or deters any acts of dishonesty from outside sources Participates in investigations and surveillance as assigned Ensures apprehensions are consistent with store theft activity Completes and distributes...Hourly payTemporary workLocal areaHome officeFlexible hours$19.5 per hour
...Prevention Supervisor you will improve company profitability by executing company programs around external theft deterrence, internal investigations and operational shortage. You will increase associate awareness of shortage opportunities through training, lead and influence...Full timeLocal area- ...through information sharing, training, research, and technology. Visit . Duties & Responsibilities The position is for a Criminal Investigator (Special Agent) with primary responsibility for prevention, detection, and investigation of substantive and conspiracy‑type...Work at officeLocal area
- Criminal InvestigationA description of the business units can be found at: are to be filled in the following area(s): CI - Criminal InvestigationConsider each location carefully when applying. If you are selected for a location, that location will become your official...
- ...foster children employment preferences. Purpose of Position Responsible for conducting thorough, impartial, and confidential investigations into allegations of misconduct, policy violations, complaints, and other law enforcement matters. Assists the Section Chief...Full timeWork at officeLocal areaImmediate startAfternoon shift
$3,095.33 - $4,594.5 per month
...on the Benefits of Working at HHS webpage . Functional Title: Investigator I Job Title: Investigator I Agency: Health & Human Services Comm... ..., and stolen disaster assistance checks and allegations of fraud. This role also involves preparing restitution agreements and...Full timeContract workTemporary workPart timeWork at officeRemote workShift work- ...through information sharing, training, research, and technology. Visit . Duties & Responsibilities The position is for a Criminal Investigator (Special Agent) with primary responsibility for prevention, detection, and investigation of substantive and conspiracy‑type...Work at officeLocal area
- ...A U.S. law enforcement agency is seeking a Criminal Investigator (Special Agent) in Austin, Texas. The role involves conducting complex investigations, recognizing illegal activities, and coordinating with multiple jurisdictions. Candidates must be U.S. citizens, eligible...
- ...by conducting advanced forensic examinations, eDiscovery, and investigative analysis across a wide range of digital platforms. This position... .... Conduct HR-related investigations, eDiscovery for lawsuits, fraud, misuse/abuse investigations, and internal police or city...Work at officeLocal area
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