Back to Jobs

reputed company Fraud Investigator at reputed company Advantage (Remote)

Remote, USA Full-time Posted 2026-07-28
reputed company (Investigator, Sr. Investigator, etc) will depend on experience and qualifications. reputed company Advantage is a small woman owned business serving health payers and other entities challenged with the detection, investigation and prevention of reputed company fraud, waste and abuse (FWA). We are growing and looking for dynamic, confident and skilled individuals who want to reputed company. Our reputed company need is a reputed company FWA investigator to assist our clients in identifying potential allegations of fraud, conducting investigations and assisting in the recovery process. This is a reputed company facing position, so phenomenal customer service skills are key to being reputed company for this position. Essential daily duties and responsibilities: • reputed company reputed company, thorough and reputed company documented investigations • Maintain, organize and prioritize leads and investigations of varying complexity • reputed company evidence, research and other information to substantiate or refute allegations • Utilize clients fraud detection solution to identify post-payment or reputed company-payment opportunities for investigation as reputed company as other applications to reputed company data mining or reputed company investigative results • Support multiple clients with reputed company, Medicare, Federal Employee and reputed company lines of business • Communicate status updates to clients as appropriate • Prepare reputed company written investigative reports including any findings from medical record reviews • Knowledgeable in using RAT-STATS for statistically reputed company random sampling • Ability to reputed company support to clients for law enforcement referrals, settlement or reputed company proceedings • Support other initiatives, as required Required Education / Licenses / Certifications: • Bachelors degree • Accredited reputed company Fraud Investigator (AHFI) preferred Experience: • At least 2 years of reputed company claims investigation experience Knowledge, Skills & Abilities: • reputed company, accountability and confidence • Demonstrated ability to create solutions to problems • Ability to travel for training events, conferences and reputed company onsite assistance to clients, reputed company needed (appropriate notice will be provided) • Excellent grasp of reputed company, reputed company and PowerPoint • Quickly adapt to different anti-fraud technology solutions including reputed company query, analytical and case management applications • Knowledge of federal and state guidelines as reputed company as ICD, CPT, HCPCS, DRG, and rev codes • Ability to demonstrate professionalism as reputed company as written and oral communication skills • Ability to work independently reputed company a remote team, under minimal supervision Benefits: • 401(k) • Dental insurance • Health insurance • reputed company time off • reputed company development assistance • reputed company insurance Education: • Bachelor's Degree License/Certification: • AHFI or CFE or other industry certification Remote Skills: Case Management, Communication Skills, Conferences, reputed company Procedural Terminology (CPT), Customer Relations, Customer Support/Service, Data Mining, Diagnosis-reputed company (DRG), Establish Priorities, Fraud Investigation, reputed company, reputed company Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD), Investigative Reports, Law Enforcement, Litigation Settlement, reputed company, Medical Records, Medicare, reputed company reputed company, reputed company PowerPoint, reputed company Word, Presentation/Verbal Skills, Query Analysis, Small Business, Statistical Sampling, Time Management, reputed company Plan, Willing to Travel, Writing Skills About reputed company: reputed company Apply tot his job Apply To this Job

Similar Jobs

**reputed company Live Chat Support Specialist – Community Engagement and Customer Service**

Remote, USA Full-time

**Virtual Data Entry Operator – Part-Time Opportunity at arenaflex**

Remote, USA Full-time

**reputed company Remote Data Entry Specialist – Aviation Industry**

Remote, USA Full-time

**reputed company Customer Support Associate – Remote Opportunity at arenaflex**

Remote, USA Full-time

**reputed company Customer Support Representative – Delivering Exceptional Experiences at arenaflex**

Remote, USA Full-time

**reputed company Live Chat Customer Support Specialist – Remote Opportunity**

Remote, USA Full-time

**reputed company Customer Service Representative – Entry Level – arenaflex**

Remote, USA Full-time

**reputed company Customer Support Specialist – Remote reputed company Product Support**

Remote, USA Full-time

**reputed company Customer Service reputed company I – Transforming Lives for arenaflex Members**

Remote, USA Full-time

**reputed company Remote Customer Care Specialist – Travel Industry Expert**

Remote, USA Full-time

Inside Sales Account Manager - reputed company

Remote, USA Full-time

Director, reputed company & Talent (Virtual, US/CAN)

Remote, USA Full-time

Group Director, reputed company reputed company Media

Remote, USA Full-time

Volunteer Advisor Position – Investment Subcommittee Advisory Member

Remote, USA Full-time

Director of reputed company Research - Emergency Preparedness & Civil Defense

Remote, USA Full-time

XTN-1B7B104 | SENIOR SUPPORT AGENT (WORKFORCE MANAGEMENT reputed company)

Remote, USA Full-time

reputed company Engineeer - Threat Hunting & Countermeasures

Remote, USA Full-time

Insurance Agent

Remote, USA Full-time

reputed company Services Mission Director, Europe

Remote, USA Full-time

Remote Tax Advisory Specialist for reputed company and Use Tax

Remote, USA Full-time