- Qlarant (4)
- Magellan Health (3)
- Molina Healthcare (3)
- Missouri Employers Mutual (3)
- State of Nebraska (2)
- State of Washington (2)
- L.A. Care Health Plan (2)
- CVS Health (2)
- CoventBridge Group (2)
- Inland Empire Health Plan (2)
- Quadrant Biosciences Inc (2)
- AdventHealth Corporate (2)
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Medicare Fraud Investigator jobs
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50 jobs
- QlarantRemote
Easily apply PostedPosted 30 days ago •- Experience in health care fraud investigation/detection involving Medicaid strongly preferred.
- Bachelor's Degree and two years’ experience in investigations…
25+ applications
· - CES, LLCRemote
Easily apply PostedPosted 17 days ago •- Experience in health care fraud investigation/detection.
- Determines investigation or case appropriateness of fraud, waste and abuse issues in accordance with…
25+ applications
·- View all CES, LLC jobs in Remote - Remote jobs - Fraud Investigator jobs in Remote
- Salary Search: Healthcare Fraud Investigator salaries in Remote
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- CVS HealthRemotePostedPosted 4 days ago •
- Provides input regarding controls for monitoring fraud related issues within the business units.
- Conducts investigations of known or suspected acts of…
25+ applications
· - CoventBridge GroupRemote in United States
Easily apply PostedPosted 6 days ago •- The Medicare Medical Review RN (Medical Reviewer III) will primarily be responsible for conducting clinical reviews of medical records during the course of…
25+ applications
· - Missouri Employers MutualRemotePostedPosted 23 days ago •
- Identifies and investigates potential fraud and works with the Special Investigation Unit investigator to provide necessary documentation that may support a…
25+ applications
·- View all Missouri Employers Mutual jobs in Remote - Remote jobs
- Salary Search: Claims Representative salaries in Remote
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- State of HawaiiOahu Island, HI$5,713 - $6,949 a monthFull-timePostedPosted 30+ days ago·
- B. One of two investigators who are responsible for the small investigative program in an agency, without higher level investigative supervisory guidance; and.
- Inland Empire Health PlanHybrid remote in Rancho Cucamonga, CAPostedPosted 30+ days ago •
- Experience in fraud, waste and abuse investigations, medical billing, pharmacy claims, or claims processing preferred.
- Assist with audit preparation, as needed.
25+ applications
· - State of NebraskaLincoln, NEEstimated $67.4K - $85.3K a yearFull-timePostedPosted 24 days ago·
- The successful applicant will assist investigators and attorneys in the unit by providing nursing expertise in analyzing medical records and charts, assessing…
- View all State of Nebraska jobs in Lincoln, NE - Lincoln jobs - Nurse jobs in Lincoln, NE
- Salary Search: Nurse Investigator salaries in Lincoln, NE
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- QlarantRemote
Easily apply EmployerActive 13 days ago •- Investigates and refers all potential fraud leads to the Investigators/Auditors.
- Completes desk review or field audits to meet applicable contract requirements…
25+ applications
·- View all Qlarant jobs in Remote - Remote jobs - Registered Nurse jobs in Remote
- Salary Search: Medical Review RN - Medicaid/MCO Review salaries in Remote
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- OptumRemote in Irvine, CA 92614PostedPosted 1 day ago •
- 2+ years of experience processing pharmacy or medical claims and/or investigating fraud (health care fraud investigations experience preferred).
25+ applications
·- View all Optum jobs in Irvine, CA - Irvine jobs - Auditor jobs in Irvine, CA
- Salary Search: Pharmacy Audit Investigator salaries in Irvine, CA
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- Magellan HealthBoise, ID 83702 (Harrison Blvd area)From $58,440 a yearFull-timePostedPosted 30+ days ago·
- This individual serves as a corporate resource on fraud, waste and abuse issues and recommends cost containment projects with an emphasis on fraud prevention.
- PeratonMiramar, FL 33027PostedPosted 23 days ago •
- The Support Clerk-Medicare will provide clerical support to complaint analyst, data analysis and investigator teams.
- Report work activity on a timely basis.
25+ applications
·- View all Peraton jobs in Miramar, FL - Miramar jobs - Support Services Clerk jobs in Miramar, FL
- Salary Search: Support Clerk - Medicare salaries
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- QlarantLos Alamitos, CAUp to $20 an hourFull-time
Easily apply PostedPosted 30+ days ago·- Experience in healthcare programs or fraud investigation/detection;
- Analyzes data for appropriateness of fraud, waste and abuse issues in accordance with pre…
- North Carolina Dept of JusticeWake County, NC$54,197 - $94,844 a yearFull-timePostedPosted 4 days ago·
- MID provides state and national training opportunities to aid employees in understanding the complexities of health care fraud investigations.
- SB Clinical Practice ManagementStony Brook, NY 11794$90,000 - $107,000 a yearFull-timePostedPosted 6 days ago·
- Develop and implement investigation strategies to address potential threats, breaches of security, fraud, misconduct, and other incidents affecting the…
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