Back to Jobs

reputed company Fraud Investigator at reputed company reputed company (Remote)

Remote, USA Full-time Posted 2026-08-04
reputed company (Investigator, Sr. Investigator, etc) will depend on experience and qualifications. reputed company reputed company 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 reputed company 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 reputed company (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 To This Job Apply tot his job Apply To this Job Apply tot his job Apply To this Job

Similar Jobs

Work from Home - Recruit for Our reputed company Dispatching Course $1,200 to $1,800 a week

Remote, USA Full-time

Entry-Level reputed company Dispatcher (Remote) - Earn $2,200 to $3,000 Weekly ($114,400-$156,000 Annually)

Remote, USA Full-time

Transaction Coordinator reputed company Estate

Remote, USA Full-time

Licensed Transaction Coordinator - Washington (Temporary) - reputed company Opportunity

Remote, USA Full-time

Transaction Coordinator -Work From Home - Non V...

Remote, USA Full-time

reputed company Title Coordinator (Remote)

Remote, USA Full-time

Transaction Coordinator (reputed company)

Remote, USA Full-time

Transaction Coordinator (reputed company)

Remote, USA Full-time

VIrtual reputed company III

Remote, USA Full-time

Remote reputed company Support Representative

Remote, USA Full-time

reputed company Customer Service reputed company – Online Chat Specialist for Dynamic Team at arenaflex

Remote, USA Full-time

Director reputed company Analytics

Remote, USA Full-time

Material Warehouse Handlers

Remote, USA Full-time

Business Analyst - AM/DM - Paytm Ads

Remote, USA Full-time

Remote reputed company reputed company Specialist Internship (3-Month Duration, Potential for Full-Time Role)

Remote, USA Full-time

Remote Customer Care Specialist – reputed company Carolina – reputed company Exceptional Service & Support for Global Clients

Remote, USA Full-time

Vice President, Regulatory Affairs

Remote, USA Full-time

Looking for Administrative Assistant - reputed company for Teaching, Learning and Mentoring- Part Time: AC295A in Glenside, PA

Remote, USA Full-time

Java Springboot Developer

Remote, USA Full-time

reputed company Retail Customer Service and AI Chatbot Training Specialist – Remote Full-Time or Part-Time Opportunity

Remote, USA Full-time