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Job Title: Remote Investigator, Special Investigations Unit - Healthcare Fraud Prevention & Detection

Remote, USA Full-time Posted 2025-11-03

Job Description:

We're seeking a highly skilled and experienced Investigator to join our Special Investigations Unit, where you'll play a critical role in preventing, detecting, and investigating healthcare fraud, waste, and abuse. As a key member of our team, you'll utilize your expertise to conduct thorough investigations, collaborate with law enforcement agencies, and develop strategies to minimize losses and promote a culture of compliance.

Key Responsibilities:

  • Conduct comprehensive investigations into suspected healthcare fraud, waste, and abuse, utilizing advanced analytical and research skills
  • Communicate effectively with federal, state, and local law enforcement agencies to facilitate the prosecution of healthcare fraud cases
  • Develop and implement controls to prevent and detect fraudulent activities, ensuring compliance with regulatory requirements
  • Provide educational programs and training to promote awareness and deterrence of healthcare fraud, waste, and abuse
  • Maintain accurate and detailed records of investigations, including documentation of case activity and evidence

Requirements:

  • 1-3 years of investigative experience in healthcare fraud, waste, and abuse, with strong knowledge of medical terminology, CPT/HCPCS coding, and healthcare claims investigation
  • Advanced skills in Microsoft Excel, with proficiency in Word, MS Outlook, and database search tools
  • Strong analytical, research, and communication skills, with the ability to interact with diverse groups and provide timely assistance
  • College degree in Criminal Justice or a related field, with certifications such as AHFI, CFE, or Certified Professional Coder preferred

What We Offer:

  • Competitive salary range: $43,888.00 - $76,500.00, with opportunities for bonuses, commissions, and short-term incentives
  • Comprehensive benefits package, including medical, dental, and vision coverage, 401(k) retirement savings plan, and Employee Stock Purchase Plan
  • Opportunities for professional growth and development, with access to training programs, education assistance, and career advancement opportunities
  • Flexible work arrangements, with the ability to work from home and collaborate with a remote team

How to Apply:

Ready to join our team and make a difference in the fight against healthcare fraud? Click the "Apply Now" button to submit your application and take the first step towards a rewarding career with our organization.

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