Remote Fraud & Abuse Investigator — CPC Certified
DaMar Staffing
- Remote job
Sentara Health Plans is seeking an Associate Fraud and Abuse Investigator / Certified Professional Coder (CPC) for a remote position with occasional travel to Virginia Beach (1x per year). The role supports investigations across providers, pharmacies, employers, members and brokers. The ideal candidate will have a Bachelor's Degree or 2+ years in Medical Coding or related healthcare fields, CPC certification (or within 12 months of hire), and strong writing, communication, and analytical skills. #J-18808-Ljbffr DaMar Staffing
- ...with expert review to surface fraud, waste, and abuse across Medicare, Medicaid,... ...not manage anyone. Strong investigators here come from healthcare... ...Nice to Have Certified Fraud Examiner (CFE). Certified... ...Certified Professional Coder (CPC). Accredited Health Care...Remote work
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and provider abuse using CPT coding guidance. You will mentor investigators, review claims against medical records, and coordinate with internal and external stakeholders to ensure...Remote job
$58.75k - $71.58k
...Retirement System, flexible and/or remote work opportunities for... ...benefits. Join our team as a Certified Police Officer - Detective! We... ...community through proactive investigations and diligent case work. As a... ...the City's current substance abuse policy. ~ Must pass City physical...Remote workPermanent employmentFull timeWork at officeLocal areaImmediate startTrial periodFlexible hours$64k - $68k
...We offer remote work opportunities (AK, AR, AZ, CO, FL,... ...adjudicated DOD background investigation for this position.... ...and reporting of suspected fraud, waste and abuse (FWA) cases as defined by... ...Knowledge of Facets • Certified Coder (CPC, CPC-P, CCA, CCS-P), AHFI...Remote workContract workTemporary workFor subcontractorInterim roleLocal areaShift work- ...Profile We offer remote work opportunities (AK, AR, AZ... ...adjudicated DOD background investigation for this position.... ...and reporting of suspected fraud, waste and abuse (FWA) cases as defined by... ...Knowledge of Facets Certified Coder (CPC, CPC‑P, CCA, CCS‑P), AHFI...Remote workContract workFor subcontractorInterim role
- ...Conducting comprehensive fraud, waste, and abuse (FWA) investigations, the full-time SIU Investigator will analyze... ...compliance with regulations in a remote work environment. Key responsibilities... ...Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), or similar certification...Remote workFull time
$65k - $88.6k
...caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste... ...at Home. While this is a remote position, occasional travel... ..., Clinical Certifications, CPC, CCS, CFE, AHFI) • Experience...Remote workFull timeTemporary workFor contractorsApprenticeshipWork at officeWork from homeHome officeMonday to Friday$50k - $70k
Overview Certified Medical Coder (CPC or CCS) - Remote | WFH job at Get It - Healthcare. Springfield, NJ. Job Summary: We are looking for a detail-oriented and motivated Certified Medical Coder to join our team. As a key member of the coding department, you will be responsible...Remote jobFull timeWork at officeWork from homeMonday to FridayFlexible hoursShift work- Centene Corp. in the United States seeks a Fraud, Waste, and Abuse (FWA) Investigator to review referrals, claims data, medical records, and provider information... ...in healthcare investigations or related audits; preferred AHFI, CFE, CPC, CPMA #J-18808-Ljbffr Centene Corp.Remote job
$65k - $88.6k
...of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and... ...We are fortunate to offer a remote opportunity for this job. Our... ..., Clinical Certifications, CPC, CCS, CFE, AHFI)....Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$27.91 - $34.87 per hour
...Stonybrookphysicians in Saint James, NY is hiring a Certified Coder for Stony Brook Children’s Service.... .... The ideal candidate will hold a CPC certification, have an Associate’s Degree... ...- $34.87 per hour, with the possibility of remote work after 90 days. #J-18808-Ljbffr...Remote workHourly payFull time- ...To gain hands-on experience in a medical coding environment, a CPC Certified Medical Coder will work remotely as a Medical Coding Assistant, responsible for reconciling electronic professional charges, reviewing missed charges, and performing basic coding reviews and...Remote work
- ...guidance from a nationally certified health and wellness... ...Description A Fraud Analyst I is responsible... ..., deter, detect and investigate acts of fraud committed... ...fraud, wire fraud, elder abuse fraud, kiting and... ...Reviews and investigates Remote Deposit Capture...Remote workHourly payContract workWork at officeLocal areaImmediate start
- Optum is a global health services company seeking a certified medical coder to join our Revenue Operations team. This role focuses on coding... ...auditors and payers. We require 2+ years of coding experience, CPC/CCS/ CCS-H credentials, and strong attention to detail....Remote job
- ...Norfolk, VA, is seeking a Manager for the Special Investigative Unit/Program Integrity (CPC) role, supporting remote work across several states. You will lead a... ...in supervision, plus strong alignment to fraud, waste and abuse controls. #J-18808-Ljbffr Sentara Health PlansRemote job
- ...To support Yale Medicine Administration, the full-time remote CPC-A Certified Medical Coder will review charge submissions for compliance with coding guidelines, perform billing processes, and ensure accurate documentation for patient clinical services. Key responsibilities...Remote workFull timeWork experience placement
$15 - $25 per hour
...Fraud Analyst - Content & Reviews Abuse is a remote review track for evaluating AI outputs across fraud analyst content reviews abuse specialist operations workflows. Reviewers grade workflow correctness, policy adherence, and stakeholder fit; flag operational risk; and...Remote jobFor contractorsWork experience placement10 hours per week- Location: Remote (Occasional Travel May Be Required) Clearance: Ability to... ...Accountant to support complex financial investigations involving fraud, waste, abuse, and mismanagement affecting... ...certification as one of the following: Certified Public Accountant (CPA), Certified...Remote workWork at office
- ...SUMMARY Under the guidance of the Fraud Operations Manager, the... ...role to prevent, detect, and investigate fraudulent activities. This role... ...theft and elder financial abuse. Additionally, the Senior Fraud... ...certification, such as Certified Fraud Examiner (CFE), Certified...Remote job
- SB CLINICAL PRACTICE MANAGEMENT PLAN INC is seeking a Certified Coder for Stony Brook Children's Service in St. James, NY. This full-time... ...compliance with guidelines and procedures. Candidates must have a CPC certification or equivalent experience. The successful candidate...Remote jobFull timeWork at office
$58.75k - $71.58k
...Retirement System, flexible and/or remote work opportunities for... ...physical examination, background investigation (to include polygraph... ...the City's current substance abuse policy. Additional Requirements... ...as required. Benefits of a Certified Police Officer: Upon...Remote workPermanent employmentFull timeLocal areaImmediate startFlexible hoursShift workAfternoon shift$70.5k - $94.4k
.... About the Role The Certified Professional Coder (CPC) is responsible for performing reviews... ...documentation to conduct low level investigations. The incumbent will also support... ...accounting, receive and review suspected fraud and to complete cases with all...Remote workLive inLocal area- ...Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims data, collaborate with internal teams, and prepare comprehensive reports for compliance and...Remote workFull time
- ...Leading complex fraud investigations in healthcare billing, coding, and claims, the full-time remote Senior Fraud Investigator will analyze large data sets to identify patterns... ...sets to detect potential fraud, waste, and abuse in healthcare billing and claims Prepare...Remote workFull time
- ...humanity and inspire hope. Overview Responsible for complex fraud and abuse investigations and data analysis to identify trends, detect fraud and... ...Coders Upon Hire required. CRT-Professional Coder, Certified - Payer (CPC-P) - UNKNOWN Upon Hire required. CRT-Outpatient Coder,...Local area
- ...Ellenco Estágios e Treinamentos is seeking a Fraud Analyst - Content & Reviews Abuse specialist contractor to evaluate AI outputs and ensure alignment... ...and capture actionable next steps for model training. Remote work options apply to the US, with a flexible schedule...Remote workFor contractorsFlexible hours
- ...Certified Medical Coder II - Surgical Coder Hybrid - Remote. Hourly salary plus monthly bonus! As Mount Sinai grows, so does our legacy in high-quality health... ...staff as needed. Qualifications: CPC or CCS-P Certification Required High School graduate...Remote workHourly payWork at office
- ...Centene Corporation seeks an Investigator to conduct fraud, waste, and abuse investigations across healthcare programs. You will review referrals, claims data, and medical records, document findings, and support case resolution while ensuring regulatory and contractual...Remote work
$53.81k - $80.73k
...misses, this role is for you. As a desk investigator with our Fraud Unit, you'll reconstruct up to six... ...Government Program Fraud and Child Welfare Abuse & Neglect database (TRAILS) check.... ...performed in a high-volume office and remote work environment dependent on business...Remote workFull timeTemporary workWork at officeLocal areaMonday to FridayFlexible hoursWeekend workAfternoon shift$85k - $105k
...Healthcare Fraud InvestigatorEmployment Type: Full-Time, Mid-Level Department: Litigation... ...CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government... ...data for evidence of fraud, waste and abuse.Review and evaluate referrals to...Remote workFull timeWork experience placementWork at officeLocal area
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