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Fraud Review Specialist Remote Jobs (NOW HIRING)

Bill Review Specialist

Lake Forest, CA ยท On-site +1

$20.25 - $28/hr

Our dynamic Bill Review team is seeking a full-time Bill Review Specialist (REMOTE) to review, audit, and process workers' compensation medical bills while ensuring compliance with state fee ...

Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review and analyze ... Previous fraud review/ investigation experience preferred * Ability to keep sensitive and ...

Job Summary Senior Compliance Review Specialist Aptive is seeking a Senior Compliance Review ... Fraud Examiner (CFE) or equivalent. * Experience reviewing federal programs, healthcare programs ...

New

Job Summary Senior Compliance Review Specialist Aptive is seeking a Senior Compliance Review ... Fraud Examiner (CFE) or equivalent. * Experience reviewing federal programs, healthcare programs ...

New

This role supports daily operational functions, performs fraud review and investigation, resolves ... This position is designated as remote; however, if you reside within a 50-mile radius of one of our ...

We are a remote first company. This role, as most of our positions, is remote. You may be required ... the ongoing review, management, and referral of potential suspicious or fraudulent activity ...

We are a remote first company. This role, as most of our positions, is remote. You may be required ... the ongoing review, management, and referral of potential suspicious or fraudulent activity ...

Daily review of all orders held in the fraud review que through the fraud prevention systems ... We would also consider a fully remote work format within the Eastern USA. Applicants to this ...

Suitability Review Specialist

Ohio, IL ยท Remote

$73K - $122K/yr

The Suitability Review Specialist is responsible for reviewing new business submissions and ... Referenced Salary Location USA, Massachusetts - Full Time Remote Working Arrangement Remote Salary ...

New

Suitability Review Specialist

New York, NY ยท Remote

$73K - $122K/yr

The Suitability Review Specialist is responsible for reviewing new business submissions and ... Referenced Salary Location USA, Massachusetts - Full Time Remote Working Arrangement Remote Salary ...

New

$73K - $122K/yr

The Suitability Review Specialist is responsible for reviewing new business submissions and ... Referenced Salary Location USA, Massachusetts - Full Time Remote Working Arrangement Remote Salary ...

New

Suitability Review Specialist

California, MD ยท Remote

$73K - $122K/yr

The Suitability Review Specialist is responsible for reviewing new business submissions and ... Referenced Salary Location USA, Massachusetts - Full Time Remote Working Arrangement Remote Salary ...

New

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Fraud Review Specialist Remote information

See salary details

$25.5K

$74.6K

$83.5K

How much do fraud review specialist remote jobs pay per year?

As of Aug 8, 2026, the average yearly pay for fraud review specialist remote in the United States is $74,649.00, according to ZipRecruiter salary data. Most workers in this role earn between $82,500.00 and $83,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a fraud review specialist remote, and why are they important?

To thrive as a Fraud Review Specialist (Remote), you need strong analytical skills, attention to detail, and experience with risk assessment or financial investigations, often supported by a degree in finance, business, or a related field. Proficiency with fraud detection tools, case management systems, and relevant databases is commonly required, and certifications like CFE (Certified Fraud Examiner) can be advantageous. Strong communication, critical thinking, and decision-making skills distinguish top performers in this role. These abilities are crucial for accurately identifying and mitigating fraudulent activities while maintaining compliance and protecting company assets.

What is a fraud review specialist?

Fraud Review Specialists are professionals who analyze transactions and account activities to detect, investigate, and prevent fraudulent activities. They review flagged transactions, communicate with customers when necessary, and work with other departments to ensure the integrity of financial operations. In remote roles, they utilize secure systems and communication tools to perform their duties from a location outside the traditional office. Their goal is to minimize financial losses and protect both the company and its customers from fraud. They often need strong analytical skills, attention to detail, and knowledge of financial regulations.

How does a remote fraud review specialist typically collaborate with other departments to resolve suspicious transactions?

As a remote Fraud Review Specialist, you'll regularly coordinate with departments such as customer service, compliance, and risk management to investigate questionable transactions. Communication is often facilitated through secure digital channels, including email, chat, and video conferencing tools. You may participate in virtual meetings to discuss cases, share findings, and recommend actions. Building strong relationships with colleagues across departments is key to ensuring thorough case resolution and maintaining compliance with company policies.
More about Fraud Review Specialist Remote jobs
What cities are hiring for Fraud Review Specialist Remote jobs? Cities with the most Fraud Review Specialist Remote job openings:
What are the most commonly searched types of Fraud Review Specialist jobs? The most popular types of Fraud Review Specialist jobs are:
What states have the most Fraud Review Specialist Remote jobs? States with the most job openings for Fraud Review Specialist Remote jobs include:
Infographic showing various Fraud Review Specialist Remote job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $74,649 per year, or $35.9 per hour.

Utilization Review Specialist

Banyan Treatment Centers - Texas

Pompano Beach, FL โ€ข Remote

$45K - $65K/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago


Job description

Utilization Review Specialist | Remote | Full-Time
$50,000 โ€“ $65,000 Annually | Weekdays (Weekend Availability as Needed)

Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50โ€“75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care organizations that fund patient treatment. Your work directly protects patient access to care and keeps the business running.

This is a high-volume, relationship-driven role for someone who thrives on precision, knows how to navigate managed care, and understands the stakes on both sides of the authorization process.

About Banyan Treatment Centers

Banyan Treatment Centersย is a leading national provider of intensive treatment for individuals facing substance use and mental health disorders. Backed byย TPG, one of the nationโ€™s largest private equity investors, Banyan is rapidly expanding access to high-quality, compassionate care.

Why Join Our Team?

  • Mission-driven work with real business impact โ€” your authorizations directly determine whether patients stay in treatment. Few roles sit closer to the intersection of clinical care and organizational sustainability.
  • Nationally recognized organization โ€” Joint Commissionโ€“accredited, with 18 locations and telehealth services nationwide, and the infrastructure to support your work at scale.
  • Remote flexibility โ€” work from anywhere while collaborating with clinical, billing, and operations teams across the country.
  • Collaborative environment โ€” partner closely with clinical, operational, and billing teams to resolve outstanding case issues, support discharge planning, and ensure timely reimbursement.
  • Room to grow โ€” join a rapidly expanding organization where UR professionals have visibility across the enterprise and opportunities to advance.
  • Comprehensive benefits including medical, dental, and vision insurance; whole and term life insurance; short- and long-term disability; 401(k) with employer match; paid time off and holidays; wellness incentives; and employee assistance and referral programs.

Key Responsibilities

  • Manage a caseload of 50โ€“75 patients, authorizing 15โ€“25 cases daily and ensuring timely utilization reviews and appropriate level of care determinations
  • Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards
  • Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations
  • Establish and maintain contracts with managed care companies and request rate increases when appropriate
  • Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement
  • Identify and address over- and underutilization trends
  • Assist in resolving outstanding case issues with insurers

Qualifications

Required:

  • High school diploma or equivalent
  • Minimum one year of utilization review experience in a psychiatric or chemical dependency setting
  • Strong organizational, documentation, and communication skills
  • Ability to manage high caseloads with accuracy and efficiency
  • Comfortable working independently in a remote environment

Preferred:

  • Graduate degree in a health or behavioral health related field
  • Clinical licensure (LCSW, LMHC, LPC, RN, or equivalent) โ€” valued but not required
  • Experience working with managed care organizations, insurance authorization, and level of care criteria
  • Familiarity with Joint Commission standards and behavioral health regulatory requirements

Apply Now

If you're experienced in utilization review, thrive in a fast-paced and high-volume environment, and want your work to matter beyond the spreadsheet, we'd like to meet you. Apply today to join the Banyan Treatment Centers corporate team.

Banyan Treatment Centers is an equal opportunity employer.