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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United Cerebral Palsy of Georgia is seeking a full-time professional to investigate health care fraud in Austin, Texas. The ideal candidate should have a minimum of three years’ experience in fraud investigations, a Bachelor's degree or equivalent, and strong analytical...SuggestedFull time- ...Senior Fraud Analyst Q2 is a leading provider of digital banking and lending solutions... ...role is responsible for identifying, investigating, and preventing fraudulent activities... .... And our benefits go beyond healthcare—offering resources for physical, mental...SuggestedWork experience placementLocal areaWork visaFlexible hours
$60k - $73k
...Job Type Full-time Description Fraud Mitigation Analyst| Location: 11149 Research Blvd, Austin, TX. | Schedule: Monday... ...risk framework. This role exercises independent judgment to investigate complex fraud schemes, serve as the final authority on disputed...SuggestedFull timeWork experience placementWork at officeMonday to Friday$56.2k - $101k
...A national healthcare organization is seeking a candidate to audit medical records and identify inappropriate billing practices. Responsibilities include performing reviews, investigating billing patterns, and recommending next steps for providers. Qualified candidates...SuggestedRemote workFlexible hours$4,000 - $4,500 per month
The Texas Workforce Commission is seeking an Investigator III in Austin, TX, to perform complex investigative work related to childcare benefit fraud. This role requires extensive analytical skills and the ability to work independently. Candidates need at least 1.5 years...Suggested- ...the Dell Medical School pursues innovation in the redesign of healthcare delivery, excellence in healthcare research, and programs in... ...SMCA also has a Level IV Trama Center. About The Clinician Investigator for Addiction Medicine Position The Dell Medical School...Live inRelocation package
- ...preparations and site inspections. Oversees the management of investigational medical products (IMP). Keys to Success: Education * A valid... ..., supervisory, or people management experience in a healthcare, clinical, academic, or related environment. Demonstrated experience...Full timeWork at officeLocal areaWeekend workAfternoon shift
$122k - $162.7k
Join AIR as a Senior Researcher with our Healthcare Innovations team. Our team works collaboratively to unravel the intertwined challenges... ...day‑to‑day project operations in roles such as principal investigator, project director, or task lead, ensuring deliverables are...Full timeContract workH1bWork at officeRemote work$155.7k - $190k
American Institutes for Research is seeking a Principal Researcher for Prescription Drug Policy within its Healthcare Innovations team. The role involves leading complex research and driving federal business development related to drug pricing models. Candidates should...Remote job- ...Fraud Investigations Optimization Project Manager, Apple Store Online Work Locations (2) Submit Resume Imagine what you could do here. The people at Apple don't just create products; they build the kind of wonder that has revolutionized entire industries. It's the...
- ...Austin, Texas, providing services across various industries like Healthcare and Education. The role includes patrol duties, customer... ...high school diploma or equivalent, and undergo a background investigation. Excellent benefits include health insurance, 401(k), and ongoing...Day shift
- ...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
- ...enforcement agency is seeking individuals with a medical background to become special agents. The role involves planning and conducting investigations into federal law violations and requires critical thinking and problem-solving skills. An emphasis is placed on maintaining...Work at office
$155.7k - $190k
The American Institutes for Research is seeking a Principal Researcher for its Healthcare Innovations team in Austin, Texas. This senior leadership role focuses on value-based specialty care and involves managing federal proposals and ensuring rigorous evidence-based healthcare...Remote job- ...JOB SUMMARY The Medical Director functions as a Principal Investigator (PI) for clinical trials being conducted at a clinical research... ...in the US or requisite training and experience ~3-5 years healthcare experience in a US community practice setting ~ Preference...Long term contractFull timePart timeCasual workLocal areaRemote workAfternoon shift
- Phase2 Technology is seeking a Clinician Investigator for Addiction Medicine at the Dell Medical School, University of Texas at Austin. This role involves providing healthcare services, conducting research, and teaching in a vibrant academic setting. Candidates should...
$127.1k - $172k
...Amazon Healthcare Security's (HealthSec) AI team is hiring a Technical Program Manager to drive delivery of AI security initiatives across Amazon Health Services (AHS). You will own cross-team coordination, dependency management, and delivery tracking across three parallel...Flexible hours$72.1k
...to Continue Location: Austin, TX The lateral police officer detective position is a commissioned peace officer assigned to the Investigations and Mitigation Division of the University of Texas Police Department. The officer will conduct thorough investigations of criminal...Full timeWork at officeTrial periodMonday to FridayShift workNight shiftWeekend work- ...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 information...Permanent employmentFor contractorsWork at officeFlexible hoursAfternoon shift
$156.6k - $215.4k
...delivery patterns Demonstrated success leading cross‑functional initiatives within large, matrixed organizations Prior experience in healthcare, financial services, or other highly regulated industries Travel: While this is a remote position, occasional travel to Humana's...Full timeTemporary workFor contractorsApprenticeshipLocal areaRemote work- ...security domain experience, so they will be an expert or would have touched all domains, not just one specialty. Cybersecurity Healthcare and Public Services Senior Manager: Our cybersecurity teams help clients identify and evaluate security gaps, subsequently...Local area
$21.22 per hour
...confidentiality of all Security/Loss Prevention and property reports/documents; release information only to authorized individuals. Conduct investigations and gather evidence. Conduct interviews with relevant parties. Follow all company policies and procedures; report accidents,...Hourly payWork experience placementSeasonal workShift workWeekend workDay shift$18 - $21 per hour
...Comply and promote LodgeWorks standards and regulations to encourage safe and efficient hotel operations. Initiate preliminary investigations into incidents. Documents and reports to supervisor. Maintain regular attendance in compliance with LodgeWorks standards as...Full timeTemporary workLocal areaHome officeFlexible hoursShift work- ...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
- ...also responsible for the more intricate and new data source collections and analysis. What You'll Do Forensic Collections and Investigations: Conduct forensic collections of digital evidence using best practices and approved software and hardware. Acquire electronic...H1bVisa sponsorshipFlexible hours
- A federal law enforcement agency is seeking Criminal Investigators to conduct complex drug-related criminal investigations and prepare detailed reports for legal proceedings. Candidates must be U.S. citizens and can expect to undergo a thorough hiring process, including...Relocation package
- A specialized consulting firm is seeking a part-time Spanish-speaking Criminal Defense Investigator in Austin, TX. The role involves conducting interviews, gathering evidence, and analyzing information to support defense cases. Candidates must have experience in criminal...Part time
- Mayer Consulting specializes in criminal defense investigation, mitigation, and voir dire support Focused on delivering high-quality services, Mayer Consulting works closely with attorneys and their clients to ensure thorough and accurate investigations. We are dedicated...Part time
- Summary THIS IS NOT AN OPEN JOB ANNOUNCEMENT** This is a public notice for Drug Enforcement Administration Criminal Investigator GL-1811-7/9/11 positions open to U.S. Citizens. A job announcement will be posted on USAJobs on April 20th, July 20th, and October 19th, 2...Permanent employmentLocal areaRelocationTrial periodWeekend work
- ...confidentiality of all Security/Loss Prevention and property reports/documents; release information only to authorized individuals. Conduct investigations and gather evidence. Conduct interviews with relevant parties. Follow all company policies and procedures; report accidents,...Work experience placementShift workNight shift
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