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Part Time Fraud Waste Abuse Jobs (NOW HIRING)

AAFES

Visual Merchandiser

Mountain Home, ID · On-site

$17.25 - $25.44/hr

Practices loss prevention procedures and alerts security and management of potential problems that may involve fraud, waste, and abuse. Additional Qualifications/Requirements Experience with Adobe ...

UroPartners LLC

Medical Assistant

Mount Prospect, IL · On-site

$21 - $24/hr

Job Type Part-time Description GENERAL SUMMARY * Work Location: 1660 Feehanville Drive, Suite 200 ... Fraud, Waste & Abuse. * Performs other position related duties as assigned. CERTIFICATIONS ...

UROPARTNERS LLC

Medical Assistant

Mount Prospect, IL · On-site

$21 - $24/hr

Work Location: 1660 Feehanville Drive, Suite 200, Mount Prospect, IL 60056 * Part Time (16-24 hours ... Fraud, Waste & Abuse. * Performs other position related duties as assigned. CERTIFICATIONS ...

Clarke County Hospital

EVS Tech (Part-Time)

Osceola, IA

$14.75 - $19.25/hr

Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on ...

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PHARMACY/PART-TIME PHARMACIST

Milwaukee, WI

$57.25 - $69/hr

Adhere to all company, local, state, and federal laws and guidelines, including HIPAA Fraud, Waste and Abuse (Medicare), and DEA Procedures. * Work collaboratively with team members to promote ...

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Part Time Fraud Waste Abuse information

What is the difference between Part Time Fraud Waste Abuse vs Part Time Compliance Officer?

AspectPart Time Fraud Waste AbusePart Time Compliance Officer
CredentialsKnowledge of fraud detection, certifications like ACFE or CFE beneficialCertifications such as CCEP, CRCM, or compliance-specific training
Work EnvironmentFinancial institutions, government agencies, healthcare, or corporate sectorsRegulatory agencies, corporations, financial institutions, healthcare
Employer & Industry UsageUsed to identify and prevent fraud, waste, and abuse in various sectorsEnsures organizational adherence to laws and regulations

Part Time Fraud Waste Abuse roles focus on detecting and preventing fraudulent activities, waste, and abuse within organizations, often requiring knowledge of fraud schemes and related certifications. Part Time Compliance Officers concentrate on ensuring organizations follow legal and regulatory standards, with certifications in compliance. While both roles involve regulatory knowledge, Fraud Waste Abuse positions are more specialized in fraud detection, whereas Compliance Officers oversee broader adherence to laws and policies.

What are the key skills and qualifications needed to thrive as a Part-Time Fraud, Waste, and Abuse Specialist, and why are they important?

To thrive as a Part-Time Fraud, Waste, and Abuse Specialist, you need strong analytical skills, attention to detail, and a background in compliance or investigations—often supported by relevant education or certifications such as Certified Fraud Examiner (CFE). Familiarity with data analysis tools, case management systems, and regulatory frameworks like HIPAA or Medicare/Medicaid guidelines is typically required. Excellent communication, integrity, and problem-solving abilities help you interact with stakeholders and handle sensitive information effectively. These skills are crucial for accurately identifying, investigating, and preventing fraudulent activities, thereby protecting organizational resources and ensuring regulatory compliance.

What are some common challenges faced by Part Time Fraud Waste Abuse investigators, and how can they effectively manage their workload?

Part Time Fraud Waste Abuse investigators often face challenges such as handling a high volume of case reviews, staying up-to-date with changing regulations, and managing sensitive information discreetly. To effectively manage their workload, they typically prioritize cases based on urgency and potential impact, utilize case management software, and maintain clear communication with team members. Building strong analytical skills and regularly participating in training sessions also help them stay efficient and accurate in detecting and reporting suspected fraud, waste, or abuse.

What do Part Time Fraud, Waste, and Abuse investigators do?

Part Time Fraud, Waste, and Abuse (FWA) investigators are responsible for identifying, reporting, and preventing improper or illegal activities within organizations, especially in areas like healthcare, insurance, and government programs. Their duties include reviewing claims, conducting audits, analyzing data for suspicious patterns, and interviewing individuals involved in suspected fraud, waste, or abuse cases. Working part-time, they often assist full-time teams in ensuring compliance with laws and organizational policies while helping to save resources and protect public funds.
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What are the most commonly searched types of Fraud Waste Abuse jobs? The most popular types of Fraud Waste Abuse jobs are:
What states have the most Part Time Fraud Waste Abuse jobs? States with the most job openings for Part Time Fraud Waste Abuse jobs include:
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Part Time Fraud Waste Abuse jobs near you
Infographic showing various Part Time Fraud Waste Abuse job openings in the United States as of July 2026, with employment types broken down into 4% As Needed, 73% Full Time, 20% Part Time, 1% Temporary, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.
Clinical Special Investigations Unit Investigator- Health Plan

Clinical Special Investigations Unit Investigator- Health Plan

Parkland Health and Hospital System

Dallas, TX • On-site

Part-time

Posted 2 days ago

Parkland Health and Hospital System rating

8.1

Company rating: 8.1 out of 10

Based on 89 frontline employees who took The Breakroom Quiz

68th of 890 rated healthcare providers

Job description

Location: Mockingbird Towers 4th FLR
PCHP- Parkland Community Health Plan
Primary Purpose
The purpose of the Parkland Community Health Plan (PCHP) Special Investigations Unit is to implement an effective compliance program that includes prevention, investigation and pursuit of fraud, waste, and abuse violations. The Clinical SIU Investigator ensures PCHP's accountability for compliance by overseeing, follow-up and resolution of investigations in partnership with state and federal programs.
Minimum Specifications
Education
  • Bachelor's degree in Nursing or a related field is required.

Experience
  • Four years of related clinical experience in the field of obtained license.
  • Three years Medicaid or CHIP Fraud, Waste, and Abuse investigatory experience.
  • Experience in provider education, a managed care organization or medical record auditing is preferred.

Equivalent Education and/or Experience
  • Four years of experience in Medicaid or Chip utilization review may be substituted for the 3 years of Medicaid or CHIP Fraud, Waste, and Abuse investigatory experience requirement.
  • Licensed Vocational Nurse (LVN) with four years of Medicaid or CHIP Fraud, Waste, and Abuse investigatory experience may be substituted for the required education and clinical experience requirement.

Certification/Registration/Licensure
  • Must have a current, unrestricted license in the State of Texas (or compact license) of at least one of the following: RN, LPC, LCSW, LMHC, LVN, PT, OT or ST license.
  • Must be currently certified and in good standing or obtain certification within twelve (12) months of hire with one of the following: Health Care Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI), Association of Certified Fraud Examiners (CFE), or National Health Care Anti-Fraud Association (NHCAA).

Skills or Special Abilities
  • Knowledge of health care programs and policies, and experience interpreting regulatory requirements.
  • Communicate clearly and concisely, both verbally and in writing, and has strong presentation skills.
  • Demonstrate strong organizational, analytical, problem solving, and project management skills.
  • Ability to build consensus on strategies and messages among peers and stakeholders.
  • Adapt to constantly changing priorities in managing various projects simultaneously.
  • Work independently and as a team member on assigned projects.
  • Excellent organization, facilitation, written and oral communication skills.
  • High degree of interpersonal skills, influence, negotiations and problem-solving abilities.
  • Ability to work cross functionally and collaborate with other departments and organizations on compliance matters.
  • High proficiency in Microsoft Excel, Word and Access applications.
  • Must be able to frequently problem solve, make decisions, interpret data, organize and analyze workflow, write, plan, and use simple arithmetic.

Responsibilities
  • Performs complex retrospective and prepayment reviews of medical records to identify potential abuse and fraud and inappropriate billing practices.
  • Investigates, analyzes, and identifies provider billing patterns to recommend payment based on medical records, claim history, billing codes, regulatory and state guidelines, and policies
  • Prepares summary of findings and recommend next steps for providers.
  • Identifies preventative measures and recommends changes to internal policies and procedures and/or provider practices to prevent future fraudulent and erroneous practices.
  • Consults investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities.
  • Performs onsite audits in conjunction with investigators and/or managers.
  • Reviews providers' claims history, licensure, and specialty. Assesses providers by interviewing staff, examining the facility and equipment, and reviewing medical records.
  • Provides instructions to the claims department for prepayment reviews.
  • Assists SIU Manager as needed with training new hires, answering questions from employees, auditing work of non-clinical investigators and assisting with provider education.
  • Audits medical records to identify inappropriate billing practices and determine medical necessity through extensive review of claims data, medical records, corporate policies, state/federal policies, and the interpretation of practice standards.
  • Consults with Chief Medical Officer and other PCHP personnel to clarify medical necessity and billing appropriateness.
  • Refers cases to applicable internal department such as Quality Management, Legal, Provider Relations and Health Services Delivery.
  • Responds to Requests for Information (RFIs) from National Benefit Integrity MEDIC, U.S. Office of Personnel Management Office of the Inspector General (OPM OIG), State Departments of Insurance (DOI), and other law enforcement agencies, as appropriate.

Requisition ID: 988265

What Parkland Health and Hospital System employees say

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About Parkland Health and Hospital System

Sourced by ZipRecruiter

Parkland Health and Hospital System, based in Dallas, TX, US, is a reputed entity in the healthcare industry. Accessible through their website parklandhealth.org, this distinguished organization operates within the public sector, primarily providing medical care and services. Parkland Health was founded with a mission to take healthcare to people who need it the most and ever since its inception it has staunchly adhered to this principle. The hospital is acknowledged for its unyielding dedication to patient care, its world-class staff, and its innovative medical breakthroughs. Alongside its traditional healthcare offerings, Parkland also provides specialized services such as burn treatment and poison control, cementing their position as a comprehensive provider of critical care.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Dallas, TX, US

Year founded

1954

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