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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$85k - $105k
Contact Government Services is seeking a Healthcare Fraud Investigator in Austin, Texas, to provide legal support for a government project. The role involves data analysis, reviewing financial records, and ensuring compliance with legal standards. The ideal candidate has...Suggested- 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...SuggestedFull timeWork experience placementWork at officeLocal area
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Humana Inc is looking for an experienced Dental Fraud and Waste Lead to join their remote team. The role involves investigating complex dental cases, completing clinical reviews, and educating a team on dental standards. Candidates should have a DDS or DMD and at least...Remote jobWork at office- ...support. Responsibilities include analyzing financial information, assisting with litigation discovery, and playing a key role in fraud investigations. Candidates should possess a Bachelor's degree in Finance or Accounting, along with a minimum of 3 years of relevant...Flexible hours
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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$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...Remote jobFlexible hours$22.6 - $25 per hour
...Program Coordinator position at the Association of Certified Fraud Examiners (ACFE) in Austin, TX. This is a full‑time, on‑site position... ...to the Exam Development Committee. Assist with security investigations related to theft of intellectual property. Develop, maintain,...Hourly payFull timeWork at officeRemote workWork from homeFlexible hours2 days per week1 day per week- ...Director The Medical Director functions as a Principal or Sub-Investigator for clinical trials being conducted at a clinical research... ...and Active license to practice medicine in TX ~3-5 years healthcare experience in a US community practice setting ~ Preference...Full timeCasual workLocal areaRemote workAfternoon shift
- Underwriter Services Association is seeking an Insurance Inspector based in Austin, Texas. The role involves conducting insurance underwriting inspections by collecting data on residential and commercial properties. Inspectors will measure property dimensions, take photographs...Flexible hours
- ...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
$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- A local government body in Austin, TX is seeking an experienced Medical Examiner Investigator to manage a team in complex death investigations. Responsibilities include leading investigative staff, ensuring compliance with regulations, and developing operational policies...Local area
- 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...
- ...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,...Full timeWork experience placementRemote workShift workAfternoon 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- ...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
$3,000 - $4,999 per month
...of Working at HHS webpage. Job Information Functional Title : Investigator II Job Title : Investigator II Agency : Health & Human Services... ...and procedures, and investigates complex and special cases of fraud, lost, stolen, and forged disaster assistance grant checks and...Full timeTemporary workPart timeWork at officeRemote workShift 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
- ...assist both guests and associates with respect to safety, security and hotel operations. * Initiate and follow-up with all investigations of crimes committed against property and persons. * Assist sick/injured guests or associates ensuring all documentation, reporting...Flexible hoursShift workNight shiftWeekend workDay shiftAfternoon shift
- 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
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- ...Clinician Investigator for Addiction Medicine The Dell Medical School at the University of Texas at Austin is seeking an exceptional physician to join the Department of Internal Medicine as a clinician-investigator for Addiction Medicine. The position will focus on health...Relocation package
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