Healthcare Fraud Investigator at Integrity Advantage (Remote)
Toms River, NJ ยท Remote
$60K - $92K/yr
AHFI or CFE or other industry certification This position is open now. Submit your application to get started.
Quick apply
Toms River, NJ ยท Remote
$60K - $92K/yr
AHFI or CFE or other industry certification This position is open now. Submit your application to get started.
Quick apply
Toms River, NJ ยท Remote
$60K - $92K/yr
AHFI or CFE or other industry certification This position is open now. Submit your application to get started.
Certified Criminal Justice Specialist (CCJS), preferred Accredited Health Care Fraud Investigator (AHFI), Strongly preferred Certified Fraud Examiner (CFE), preferred Certified Healthcare Compliance ...
Certified Criminal Justice Specialist (CCJS), preferred Accredited Health Care Fraud Investigator (AHFI), Strongly preferred Certified Fraud Examiner (CFE), preferred Certified Healthcare Compliance ...
Accredited Healthcare Fraud Investigator (AHFI) * Certified Professional Medical Auditor (CPMA) - Key Competencies * Strong analytical and critical-thinking skills. * Attention to detail.
Accredited Healthcare Fraud Investigator (AHFI) * Certified Professional Medical Auditor (CPMA) - Key Competencies * Strong analytical and critical-thinking skills. * Attention to detail.
Norfolk, VA ยท Hybrid
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job-related designation preferred. Knowledge of Plan policies and procedures in all facets of benefit programs management with ...
Norfolk, VA ยท Hybrid
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job-related designation preferred. Knowledge of Plan policies and procedures in all facets of benefit programs management with ...
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). โข Experience working in group health insurance, particularly within claims processing or operations. โข ...
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). โข Experience working in group health insurance, particularly within claims processing or operations. โข ...
New York, NY ยท On-site +1
$21.82 - $51.06/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). โข Experience working in group health insurance, particularly within claims processing or operations. โข ...
New York, NY ยท On-site +1
$21.82 - $51.06/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). โข Experience working in group health insurance, particularly within claims processing or operations. โข ...
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Long Beach, CA ยท Remote
$21.82 - $51.06/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). Experience working in group health insurance, particularly within claims processing or operations. Working ...
Long Beach, CA ยท Remote
$21.82 - $51.06/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). Experience working in group health insurance, particularly within claims processing or operations. Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). Experience working in group health insurance, particularly within claims processing or operations. Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). Experience working in group health insurance, particularly within claims processing or operations. Working ...
$70K - $90K/yr
Accredited Healthcare Fraud Investigator (AHFI), * Certified Fraud Specialist (CFS), * Certified Fraud Examiner (CFE), * Certified Forensic Interviewer (CFI), or * Certified in Healthcare Compliance ...
$70K - $90K/yr
Accredited Healthcare Fraud Investigator (AHFI), * Certified Fraud Specialist (CFS), * Certified Fraud Examiner (CFE), * Certified Forensic Interviewer (CFI), or * Certified in Healthcare Compliance ...
Atlanta, GA ยท On-site
$65 - $90/hr
Fraud certification from CFE, AHFI, AAPC, or coding certificates preferred. * Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation ...
New
Atlanta, GA ยท On-site
$65 - $90/hr
Fraud certification from CFE, AHFI, AAPC, or coding certificates preferred. * Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation ...
New
$70K - $90K/yr
Accredited Healthcare Fraud Investigator (AHFI), * Certified Fraud Specialist (CFS), * Certified Fraud Examiner (CFE), * Certified Forensic Interviewer (CFI), or * Certified in Healthcare Compliance ...
$70K - $90K/yr
Accredited Healthcare Fraud Investigator (AHFI), * Certified Fraud Specialist (CFS), * Certified Fraud Examiner (CFE), * Certified Forensic Interviewer (CFI), or * Certified in Healthcare Compliance ...
Minnetonka, MN ยท On-site
Accredited Health Care Fraud Investigator (AHFI) * Certified Fraud Examiner (CFE) * Healthcare, health plan or provider SIU experience required * Proven investigatory skill; ability to organize ...
Minnetonka, MN ยท On-site
Accredited Health Care Fraud Investigator (AHFI) * Certified Fraud Examiner (CFE) * Healthcare, health plan or provider SIU experience required * Proven investigatory skill; ability to organize ...
Kansas City, MO ยท On-site
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI) * Medical License: Registered Nurse (RN), Licensed Practical Nurse (LPN), pharmacist, physician Blue Cross and Blue ...
Kansas City, MO ยท On-site
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI) * Medical License: Registered Nurse (RN), Licensed Practical Nurse (LPN), pharmacist, physician Blue Cross and Blue ...
Minnetonka, MN ยท On-site
Accredited Health Care Fraud Investigator (AHFI) * Certified Fraud Examiner (CFE) * Healthcare, health plan or provider SIU experience required * Proven investigatory skill; ability to organize ...
Quick apply
Minnetonka, MN ยท On-site
Accredited Health Care Fraud Investigator (AHFI) * Certified Fraud Examiner (CFE) * Healthcare, health plan or provider SIU experience required * Proven investigatory skill; ability to organize ...
An Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), or Certified Internal Auditor (CIA) designation is preferred. The company will provide equal employment and ...
An Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), or Certified Internal Auditor (CIA) designation is preferred. The company will provide equal employment and ...
Mountlake Terrace, WA ยท On-site
$80 - $118/hr
Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI). (Preferred) * (2) years of active experience in auditing and investigating in ...
New
Mountlake Terrace, WA ยท On-site
$80 - $118/hr
Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI). (Preferred) * (2) years of active experience in auditing and investigating in ...
New
Atlanta, GA ยท On-site
$87K - $130K/yr
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job related designation preferred. * Experience investigating Medicaid market trends in Colorado, Kansas, Arkansas, and ...
Atlanta, GA ยท On-site
$87K - $130K/yr
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job related designation preferred. * Experience investigating Medicaid market trends in Colorado, Kansas, Arkansas, and ...
Kansas City, MO ยท On-site
$65 - $95/hr
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI) * Medical License: Registered Nurse (RN), Licensed Practical Nurse (LPN), pharmacist, physician * Licensed Clinal ...
Kansas City, MO ยท On-site
$65 - $95/hr
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI) * Medical License: Registered Nurse (RN), Licensed Practical Nurse (LPN), pharmacist, physician * Licensed Clinal ...
Minnetonka, MN ยท On-site
$70 - $120/hr
Accredited Health Care Fraud Investigator (AHFI) * Healthcare, health plan or provider SIU experience required * Proven investigatory skill; ability to organize, analyze, and effectively determine ...
Minnetonka, MN ยท On-site
$70 - $120/hr
Accredited Health Care Fraud Investigator (AHFI) * Healthcare, health plan or provider SIU experience required * Proven investigatory skill; ability to organize, analyze, and effectively determine ...
$8.89 - $13.70
16% of jobs
$15.17 is the 25th percentile. Wages below this are outliers.
$13.70 - $18.51
29% of jobs
The median wage is $19.71 / hr.
$18.51 - $23.32
19% of jobs
$27.58 is the 75th percentile. Wages above this are outliers.
$23.32 - $28.13
12% of jobs
$28.13 - $32.93
8% of jobs
$32.93 - $37.74
5% of jobs
$37.74 - $42.55
4% of jobs
$42.55 - $47.36
2% of jobs
$47.36 - $52.16
2% of jobs
$52.16 - $56.97
1% of jobs
$56.97 - $61.78
1% of jobs
$8
$26
$61
| Aspect | Ahfi | HVAC Technician |
|---|---|---|
| Required Certifications | Typically none or specialized safety certifications | HVAC certification, EPA certification |
| Work Environment | Industrial, manufacturing, or safety-focused settings | Residential, commercial, or industrial HVAC systems |
| Industry Usage | Used in safety and industrial sectors | Commonly employed in building climate control |
| Job Focus | Safety, compliance, and industrial processes | Installation, maintenance, and repair of HVAC systems |
Ahfi and HVAC Technician roles differ mainly in their focus and work environment. Ahfi professionals often work in industrial or safety-related settings with minimal certifications, while HVAC Technicians focus on climate control systems, requiring specific certifications. Both roles are essential in their respective industries but serve different purposes and environments.
The top searched job categories for Ahfi jobs are:

$60K - $92K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 8 days ago
Levels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications.
Integrity Advantage is a small woman owned business serving health payers and other entities challenged with the detection, investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and looking for dynamic, confident and skilled individuals who want to grow with us. Our current need is a healthcare FWA investigator to assist our clients in identifying potential allegations of fraud, conducting investigations and assisting in the recovery process. This is a client facing position, so phenomenal customer service skills are key to being hired for this position.
Essential daily duties and responsibilities:
Perform timely, thorough and well documented investigations
Maintain, organize and prioritize leads and investigations of varying complexity
Gather evidence, research and other information to substantiate or refute allegations
Utilize client’s fraud detection solution to identify post-payment or pre-payment opportunities for investigation as well as other applications to perform data mining or track investigative results
Support multiple clients with Medicaid, Medicare, Federal Employee and Commercial lines of business
Communicate status updates to clients as appropriate
Prepare well written investigative reports including any findings from medical record reviews
Knowledgeable in using RAT-STATS for statistically valid random sampling
Ability to provide support to clients for law enforcement referrals, settlement or legal proceedings
Support other initiatives, as required
Required Education / Licenses / Certifications:
Bachelor’s degree
Accredited Healthcare Fraud Investigator (AHFI) preferred
Experience:
At least 2 years of healthcare claims investigation experience
Knowledge, Skills & Abilities:
Integrity, accountability and confidence
Demonstrated ability to create solutions to problems
Ability to travel for training events, conferences and provide onsite assistance to clients, when needed (appropriate notice will be provided)
Excellent grasp of MS Word, Excel and PowerPoint
Quickly adapt to different anti-fraud technology solutions including ad-hoc query, analytical and case management applications
Knowledge of federal and state guidelines as well as ICD, CPT, HCPCS, DRG, and rev codes
Ability to demonstrate professionalism as well as written and oral communication skills
Ability to work independently within a remote team, under minimal supervision
401(k)
Dental insurance
Health insurance
Paid time off
Professional development assistance
Vision insurance
Education:
Bachelor's Degree
License/Certification:
AHFI or CFE or other industry certification
This position is open now. Submit your application to get started.