Top 17 insurance fraud Jobs in remote

LTC Fraud Investigator
John Hancock Life Insurance Company (U.S.A.) —Remote
- $73,350 - $122,250 a year
- Full-time
- Remote
- Mid-level
- 3 years
- SQL
- AD&D insurance
- Paid holidays
12d
SME - Medicaid Program Integrity and Claims Audits
BerryDunn —Remote
- $120,000 - $140,000 a year
- Full-time
- Bachelor of Science
- Research
- Analysis skills
- Dental insurance
Phone Premium Auditor (Experienced)
ARMStrong Insurance Services —Remote
- $31 - $35 an hour
- Full-time
- Microsoft Word
- Mid-level
- Commercial
- Paid holidays
- Disability insurance
Quick Apply
Claims Investigator - Part Time
CoventBridge Group —Shreveport, LA
- Part-time
- Remote
- Writing skills
- Mid-level
- Windows
- Paid training
- Fuel card
Product Manager, Insurance Data & Compliance
Shift Technology —Remote
- $120,000 - $150,000 a year
- Full-time
- Hybrid work
- 5 years
- Product management
- Senior level
- Paid holidays
- Paid time off
Premium Auditor - Advanced Auditor Division
ARMStrong Insurance Services —Remote
- $26.44 - $31.25 an hour
- Full-time
- Mid-level
- Bachelor's degree
- Business
- Paid holidays
- Disability insurance
Quick Apply
12d
Insurance Investigator - Surveillance
RH Wine & Co LLC —Saint Charles, IL
- $45,000 - $75,000 a year
- Full-time
- Remote
- Computer literacy
- Mid-level
- Driver's License
- Mileage reimbursement
- Paid holidays
Quick Apply
Claims Investigator - Full Time
CoventBridge Group —Los Angeles, CA
- $28 - $31 an hour
- Weekends as needed
- Remote
- Writing skills
- Research
- Mid-level
- Paid training
- Fuel card
Medical Claim Auditor
Gallagher Benefit Services —Rolling Meadows, IL
- $67,500 - $131,500 a year
- Full-time
- Remote
- 5 years
- HIPAA
- SQL
- Paid parental leave
- Health savings account
12d
Pharmacy Claims Auditor (Remote)
Independence Blue Cross —Philadelphia, PA
- Remote
- Microsoft Outlook
- Mid-level
- Analysis skills
7d
Senior Investigator – Special Investigations Unit
West Bend Insurance Company —Phoenix, AZ
- $77,204 - $97,000 a year
- Full-time
- Remote
- 8 years
- Presentation skills
- Mentoring
- Health savings account
- Disability insurance
Product Owner II, Claims Fraud Special Investigations Unit (SIU)
Liberty Mutual —Remote
- $106,000 - $197,000 a year
- Full-time
- Remote
- Computer Science
- 3 years
- Bachelor's degree
1d
Insurance Defense Attorney - Hybrid/Remote
Goldberg Miller & Rubin —New York, NY
- From $100,000 a year
- Remote
- Writing skills
- Mid-level
- Organizational skills
- Health savings account
- Health insurance
Quick Apply
Sr. Consultant - Client Success Anti-Fraud Analytics (SIU / P&C)
Ignite Insurance Systems —Jersey City, NJ
- Full-time
- Remote
- 18 years or older
- Microsoft Excel
- 6 years
- Health insurance
- Paid time off

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insurance fraud jobs near remote

LTC Fraud Investigator

John Hancock Life Insurance Company (U.S.A.) -
Remote

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Job Details

Full-time
$73,350 - $122,250 a year
12 days ago

Benefits

AD&D insurance
Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Adoption assistance
Vision insurance
Life insurance

Qualifications

Customer communication

Full Job Description

We’re looking for a detail-oriented, analytical LTC Fraud Investigator to help strengthen our Long-Term Care (LTC) Fraud, Waste & Abuse (FWA) program. In this role, you’ll turn claims and operational data into insights that support investigations, surface emerging fraud trends, and improve processes and controls across the program.

Position Responsibilities:

Lead targeted customer outreach to explain updated claim reimbursement controls, drive adoption, and support understanding and compliance.
Analyze LTC claims and provider billing patterns to identify potential fraud, waste, and abuse.
Prepare data extracts, dashboards, and concise analytic summaries to support case development and investigations.
Monitor and communicate emerging fraud schemes; help design mitigations, controls, and process improvements.
Partner cross-functionally with investigators, clinical teams, and technology teams to improve fraud operations and detection capabilities.
Gather and document business needs (requirements, user stories, process flows) for enhancements to fraud detection and case management tools.
Support performance monitoring and reporting for the LTC FWA program, and contribute to continuous improvement across fraud operations.

Qualifications:

3–5 years of experience in Long-Term Care (LTC), healthcare/insurance business analysis, and/or Fraud, Waste & Abuse (FWA)
Strong analytical and critical-thinking skills; able to interpret complex claims and operational data
Ability to translate findings into clear artifacts (business requirements, user stories, process flows)
Advanced Excel skills and comfort with large datasets; familiarity with SQL/SAS and/or BI tools (Power BI/Tableau) a plus
Clear written and verbal communicator; able to work effectively with both technical and non-technical stakeholders while managing multiple priorities
Experience with fraud investigations/SIU and familiarity with Medicaid and/or commercial LTC benefits and fraud/case management tools preferred

When you join our team:

We’ll empower you to learn and grow the career you want.
We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.
As part of our global team, we’ll support you in shaping the future you want to see.

This posting supports an ongoing hiring initiative for existing and/or future vacancies.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [email protected].

Referenced Salary Location

USA, Massachusetts - Full Time Remote

Working Arrangement

Remote

Salary range is expected to be between

$73,350.00 USD - $122,250.00 USD

Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. If you are applying for this role outside of the primary location, please contact [email protected] for the salary range for your location.

Manulife/John Hancock offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension/401(k) savings plans and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in the U.S. includes up to 11 paid holidays, 3 personal days, 150 hours of vacation, and 40 hours of sick time (or more where required by law) each year, and we offer the full range of statutory leaves of absence.

We use data and analytics technologies, such as artificial intelligence (AI), and automated processing tools, to analyze and process the information you provide to us or third parties in the application process. For more information, please refer to our personal information collection statement.

Know Your Rights I Family & Medical Leave I Employee Polygraph Protection I Right to Work I E-Verify

Company: John Hancock Life Insurance Company (U.S.A.)

Apply Now

Refine Your Search

insurance fraud jobs in remote

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SME - Medicaid Program Integrity and Claims Audits

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Claims Investigator - Part Time

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Medical Claim Auditor

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