Top 30 Work from home fraud Jobs in Florida

SIU Investigator
Centene —Florida
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Fraud Investigator II
Suncoast Credit Union —Tampa, FL
- $60,000 - $80,000 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- Analysis skills
- Paid parental leave
- Paid holidays
6d
Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home
The Cigna Group —Miami, FL
- Online Application
- Remote
- Spanish
- Analysis skills
- Conflict management
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Florida
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Corporate Ethics & Compliance Investigator
Centene —Florida
- $107,700 - $199,300 a year
- Full-time
- Remote
- 7 years
- Management
- HIPAA
- Paid holidays
- Health insurance
Surveillance Agent
Marshall Investigative Group —Fort Lauderdale, FL
- $22 - $32 an hour
- Part-time
- Remote
- Microsoft Word
- 11+ years
- Research
Quick Apply
9d
Senior Fraud Data Analyst
Suncoast Credit Union —Tampa, FL
- $75,000 - $117,000 a year
- Full-time
- Remote
- 6 years
- Computer Science
- Finance
- Paid parental leave
- Paid holidays
Auditor/Investigator II
Qlarant —Florida
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
VP FRAUD
TCM Bank, N.A. —Tampa, FL
- $155,000 - $175,000 a year
- Full-time
- Remote
- Writing skills
- Finance
- 8 years
- Continuing education credits
- Paid parental leave
Ethics and Compliance Specialist (Investigations and Audit)
Chromalloy —Palm Beach Gardens, FL
- $79,200 - $103,950 a year
- Overtime
- Remote
- Up to 50% travel
- 5 years
- Pass drug screening
- Wellness program
- Paid holidays
Quick Apply
Senior Compliance Investigator
Centene —Florida
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Coding Auditor
Ascension —Jacksonville, FL
- $31.35 - $42.40 an hour
- Full-time
- Remote
- High school diploma or GED
- Travel
- 1 year
- Disability insurance
- Health insurance
1d
Surveillance Investigator
SPi Investigations —Orlando, FL
- $24 - $30 an hour
- Weekends as needed
- Remote
- Spanish
- English
- Mid-level
- Opportunities for advancement
- Flexible schedule
Quick Apply
13d
Certified Professional Coder, Special Investigations Unit (Aetna SIU)
CVS Health —Florida
- $43,888 - $93,574 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
1d
Auditor, Risk Adjustment
Oscar Health —Miami, FL
- $82,717 - $108,566 a year
- Remote
- Mid-level
- Bachelor's degree
- Travel
- Paid parental leave
- Paid holidays
Quick Apply
Senior Manager, Payments and Fraud
Stellar IT Solutions LLC —Miami, FL
- $65 - $75 a year
- Contract
- Remote
- Microsoft Excel
- 5 years
- Finance
Quick Apply
Premium Auditor
ARMStrong Insurance Services —Clearwater, FL
- $44 - $50 an hour
- Full-time
- Remote
- Microsoft Word
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply
Medicare Cost Report Auditor III
BlueCross BlueShield of South Carolina —Florida
- $57,790 - $110,388 a year
- Full-time
- Remote
- CPA
- Data analysis skills
- Finance
- Health insurance
- Dental insurance
Premium Field Auditor
ARMStrong Insurance Services —Fort Myers, FL
- $44 - $50 an hour
- Part-time
- Remote
- Microsoft Word
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply
Premium Field Auditor PT
ARMStrong Insurance Services —Miami, FL
- $44 - $50 an hour
- Full-time
- Remote
- Microsoft Word
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply

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SIU Investigator

Centene -
Florida

Apply Now

Job Details

Full-time
$56,200 - $101,000 a year

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Healthcare financial misconduct investigations
Data mining
Health data analysis
Bachelor's degree in business
Mid-level
Suspicious activity investigations
Data summary reports
Criminal Justice
Audit Reporting
Investigative data analysis
Insurance investigation report preparation
Outlier detection
Healthcare billing investigations
Case referral
1 year
Insurance claims auditing
Business
Healthcare claims compliance audits
Bachelor's degree in criminal justice

Full Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Please note: candidates who reside in Florida are highly preferred.

Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.

Conduct investigations of potential waste, abuse, and fraud
Document activity on each case and refer issues to the appropriate party
Perform data mining and analysis to detect aberrancies and outliers in claims
Develop new queries and reports to detect potential waste, abuse, and fraud
Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions
Assist with complex allegations of healthcare fraud
Prepare summary and/or detailed reports on investigative findings for referral to Federal and State agencies
Complete various special projects and audits
Performs other duties as assigned
Complies with all policies and standards

Education/Experience:

Bachelor's Degree Business, Criminal Justice, Healthcare, or related field, or equivalent experience required
1+ years Medical claim investigation, medical claim audit, medical claim analysis, or fraud investigation required

Pay Range: $56,200.00 - $101,000.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

work from home fraud jobs in florida

SIU Investigator

Fraud Investigator II

Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home

Senior Investigator, Special Investigations Unit (Aetna SIU)

Corporate Ethics & Compliance Investigator

Surveillance Agent

Senior Fraud Data Analyst

Auditor/Investigator II

VP FRAUD

Ethics and Compliance Specialist (Investigations and Audit)

Senior Compliance Investigator

Coding Auditor

Surveillance Investigator

Certified Professional Coder, Special Investigations Unit (Aetna SIU)

Auditor, Risk Adjustment

Senior Manager, Payments and Fraud

Premium Auditor

Medicare Cost Report Auditor III

Premium Field Auditor

Premium Field Auditor PT

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