Remote Senior Investigator - Healthcare Fraud & Compliance
UnitedHealthcare
- Remote job
UnitedHealthcare seeks a Senior Investigator to identify and prevent healthcare fraud, waste and abuse. The role uses claims data and guidelines to spot aberrant billing, with potential fieldwork for records and interviews. The position is Monday–Friday with standard business hours and telecommuting options across the U.S., with a preference for New Jersey residents. The successful candidate will manage investigations, collaborate with SIU leadership, and maintain robust documentation while #J-18808-Ljbffr UnitedHealthcare
- ...tomorrow.Section 1: Position SummaryThe Senior Fraud Investigator is a senior individual contributor... ...coordinationPartner with operations, compliance, legal, technology, and other stakeholders... ...experience preferredFor all virtual remote positions, in order to ensure...Remote workSeniorFraudFull timeSecond job
- ...Highmark Inc. seeks a seasoned investigator to develop and maintain an anti-fraud program, conduct field investigations,... ...misappropriated funds while ensuring compliance with internal controls. The role requires 5+ years in healthcare fraud investigations, strong...SeniorFraudWork at office
- ...CA invites applications for the Special Investigations Investigator, Consultant role in our SIU. You will conduct investigations into healthcare fraud, waste, and abuse, report findings to the SIU manager, and ensure compliance with policies and laws. The position requires...SeniorFraudWork at office2 days per week
- ...Centene Corporation seeks an Investigator to conduct fraud, waste, and abuse investigations across healthcare programs. You will review referrals, claims data, and medical... ...while ensuring regulatory and contractual compliance. Responsibilities include preparing reports,...Remote workFraud
- ...Compliance Investigator At Fresenius Medical Care, we are the... ...care across the entire healthcare journey. Guided by our... ...in the context of fraud, embezzlement, corruption... ...with both junior and senior-level employees,... ...essential functions. Remote with travel as needed...Remote workFraudWork experience placementLocal areaWorldwideFlexible hours
$77.1k - $92.52k
...: 10041 Category: Compliance Agency: Elderplan... ...Regular Full-Time Office: Remote Salary: $77,099... ...challenges of affordable healthcare continue to create new opportunities... ...: The SIU Fraud Investigator is responsible for identifying...Remote workFraudFull timePart timeWork at officeFlexible hours- ...today. About the Role As our Senior Fraud Analyst for Consumer Lending... ...automated block and manual investigation policies. Advanced Risk Tooling... ...workflows. Regulatory & Compliance Liaison: Coordinate with the... ...Health, dental, and vision plans Remote work environment, although...Remote workSeniorFraud
$500 per month
...Senior Fraud Analyst – Fraud Investigations & Financial Crimes Monitoring Remote - North America Alpaca is a US-headquartered, global leader in agent-first brokerage... ...Securities' dynamic and fully remote Compliance team dedicated to safeguarding the integrity...Remote workSeniorFraudHome office- ...for onboarding and KYC. Collaborate with Product, Data, Compliance, and external vendors. Balance security, conversion,... ...and BI tools (Databricks) experience. Strong KYC and fraud prevention knowledge. Fully remote work within Brazil. Medical, dental, life insurance, meal...Remote jobSeniorFraudHome officeFlexible hours
$85k - $97.5k
...Senior Fraud AnalystThe Senior Fraud Analyst supports the Credit Union... ...program by monitoring, investigating, analyzing, and escalating fraud... ...banking, digital account opening, remote deposit capture, card-not-... ..., Cybersecurity, Payments, Compliance, and BSA/AML during fraud...Remote workSeniorFraudFull timePart timeWork at office- ...Solventum seeks a Senior Managing Counsel to lead commercial contracting for the Medical... ...with sales, pricing, finance, and compliance to structure innovative GPO/IDN arrangements... ...agreements. You will advise on healthcare fraud, antitrust, governance, and related compliance...Remote jobSeniorFraud
$77.6k - $176k
Healthcare Engineer, SeniorThe Opportunity:Manages the... ...infrastructures. Ensures compliance with building codes... ...subject to a government investigation and may need to meet... ...protect against identity fraud. You are expected to... ...cameras on during meetings.Remote: If this position is...Remote workSeniorFraudFull timeContract workPart timeWork at officeLocal area$60.2k - $107.4k
...Senior Investigator At UnitedHealthcare, we're simplifying the health care experience, creating... ..., investigation and prevention of healthcare fraud, waste, and abuse. The Senior... ...waste, and abuse referrals Ensure compliance of applicable federal/state regulations...Remote workSeniorFraudMinimum wageFull timeTemporary workWork experience placementLocal area- ...are at the forefront of healthcare innovation. Our robust... ..., Commercial Legal Senior Counsel - Genetic Kidney... ...respected Legal and Compliance Department, based at our... ...related to healthcare fraud and abuse law,... ...more.Flex Designation:Remote-EligibleFlex Eligibility...Remote workSeniorFraudFull timeSummer workWork at officeFlexible hours2 days per week
$63.3k - $114.3k
...for conducting internal investigations of concerns of... ...making recommendations to senior management for corrective... ...Corporate Integrity and Compliance Program and regulations. Certified Fraud Examiner (CFE) designation... ...days in office; 2 days remote. #LI-MM1 #LI-Hybrid...Remote workFraudFull timeWork experience placementWork at officeFlexible hours3 days per week- ...That Shape the Future of Healthcare Network ComplianceAt... ...provider access to regulatory compliance and network performance.We’re looking for a Senior Product Manager -... ...flexibility - you choose between remote, hybrid or in-office•... ...unavailableRECRUITMENT FRAUD ALERTWe understand that...Remote workSeniorFraudFull timeWork at officeRelocationFlexible hours
$109.62k - $135.53k
...Incumbent in this classification functions as lead person over Fraud Investigators and may supervise clerical or administrative support.... ...regarding fraud prevention and awareness programs. Maintains compliance with principles of accepted employee conduct as identified...Remote workSeniorFraudDaily paidContract workFor contractorsCasual workLocal areaFlexible hours$140k - $165k
...mission to transform the U.S. healthcare system — and we're the only... ...are seeking an exceptional Senior Strategic Accounts Manager... ...individuals who are comfortable with remote work and occasional travel to... ...Teladoc Health and more. Fraud and Security Notice: Please...Remote workSeniorFraudFlexible hours- ...Conducting non-field investigations of suspected fraud or illegal activities, the full-time Senior Internal Security Investigator will work remotely, interviewing witnesses, evaluating information credibility, and providing training to support the claims handling process...Remote workSeniorFraudFull time
$25 - $28 per hour
...Sr. Compliance Specialist FreedomCare is a healthcare company that has been dedicated to revolutionizing the home care industry since 2016. We support... ..., and responding to internal/external audits, investigating Fraud, Waste & Abuse claims. The Compliance Specialist...Remote workSeniorFraud- ...Independently leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator will utilize... ...support corrective actions in a remote work environment. Key responsibilities... ...in Business, Criminal Justice, Healthcare Administration, Public Health,...Remote workSeniorFraudFull time
- ...ALASKA, LLC Telework The Fraud Analyst III Senior OMI actively supports the United States... ...an expert for all Office of Market Investigator analyst tasks and be the point... ...case management systems and various compliance, workflow, and database systems....Remote workSeniorFraudFor contractorsCasual workWork at office
$211.6k - $290.95k
...improve lives by helping healthcare professionals do their... ...: Job Description: Senior Managing Counsel,... ...escalations involving legal, compliance, financial, and... ...leaders on healthcare fraud and abuse, antitrust,... ...stakeholders. Work Location Remote (United States) Travel...Remote jobSeniorFraudContract workH1bLocal areaWorldwideRelocation packageFlexible hours- ...The Senior Clinical Coder serves as a subject... ..., regulatory compliance, and appropriate... ...in a fast-paced, remote environment and is... ...continuous improvement in healthcare operations.... ..., potential fraud, and quality concerns... ...background investigation Desired Qualifications...Remote workSeniorFraudFull timeWork at officeWork from homeHome office
- ...Blue Shield of CA is seeking a Special Investigations Investigator, Consultant to join the SIU team in Oakland. You will conduct investigations into health care fraud, waste, and abuse, adhering to company policies, legal requirements, and applicable regulations. The role...SeniorFraud
- ...Model.Job DescriptionProtect. Investigate. Lead.At CHEP, we don’t just... ...protect trust. We’re looking for a Senior Asset Protection Investigator... ....Monitor and implement fraud prevention measures, leading... ...stock match program, and MORE!Remote TypeFully RemoteSkills to succeed...Remote workSeniorFraudFull timeTemporary workLocal areaNight shift
- ...CVS Health is seeking a Senior Investigator in Ohio to conduct high‑level investigations of healthcare fraud and abuse, including Medicaid matters, handling sensitive, national cases and providing testimony when required. Requirements: 4+ years in healthcare fraud investigations...SeniorFraud
- ...Praescient Analytics is searching for a Senior Investigative Analyst to enhance federal fraud detection and program integrity initiatives. The role encompasses analyzing various forms of data to uncover fraud indicators and producing high-quality intelligence for governmental...Remote workSeniorFraud
- ...seeking a Debit Card Disputes Clerk/Financial Investigations Support Specialist to investigate debit card disputes and maintain compliance with various regulations.The ideal... ...understanding of VISA rules, and previous debit card fraud experience. This full-time role requires...Remote workFraudFull timeWork at office
- ...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 workFraud
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