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via Prowlremote.com

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

Anywhere
Full-time
Posted 12/2/2025
Verified Source
Key Skills:
Healthcare fraud investigation
Medical terminology
CPT/HCPCS coding
Microsoft Excel
Analytical skills
Research skills
Communication skills

Compensation

Salary Range

$44K - 77K a year

Responsibilities

Conduct investigations into healthcare fraud, collaborate with law enforcement, develop fraud prevention controls, provide training, and maintain investigation records.

Requirements

1-3 years healthcare fraud investigative experience, knowledge of medical coding, strong analytical and communication skills, college degree in Criminal Justice or related field, preferred certifications (AHFI, CFE, CPC).

Full Description

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. Apply To This Job Apply for this job

This job posting was last updated on 12/6/2025

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