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Remote Cfe Jobs (NOW HIRING)

The State of Arizona

FINANCIAL INVESTIGATOR II

Phoenix, AZ · On-site +1

$68K - $71K/yr

Obtained or interest in obtaining a Certified Fraud Examiner (CFE) designation. * Well-developed ... A hybrid remote work schedule is a management option and not an employee entitlement or right. An ...

Humana, Inc.

Senior Fraud and Waste Investigator

While this is a remote position, occasional travel to Humana's offices for training or meetings may ... D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI) * Understanding of healthcare industry ...

NORTHROP GRUMMAN

Manager Programs 2

Sunnyvale, CA · Remote

$161.10K - $241.70K/yr

This position is remote with up to 50% onsite. * Program Manager for Sunnyvale CA Aftermarket ... Managing Government/customer supplied property or information (GFE, CFE, etc.) * Managing suppliers ...

NORTHROP GRUMMAN

Manager Programs 2

Sunnyvale, CA · Remote

$161.10K - $241.70K/yr

This position is remote with up to 50% onsite. * Program Manager for Sunnyvale CA Aftermarket ... Managing Government/customer supplied property or information (GFE, CFE, etc.) * Managing suppliers ...

NORTHROP GRUMMAN

Manager Programs 2

Sunnyvale, CA · Remote

$161.10K - $241.70K/yr

This position is remote with up to 50% onsite. * Program Manager for Sunnyvale CA Aftermarket ... Managing Government/customer supplied property or information (GFE, CFE, etc.) * Managing suppliers ...

Northrop Grumman Corporation

Manager Programs 2

Sunnyvale, CA · On-site +1

$161.10K - $241.70K/yr

This position is remote with up to 50% onsite. * Program Manager for Sunnyvale CA Aftermarket ... Managing Government/customer supplied property or information (GFE, CFE, etc.) * Managing suppliers ...

Genpact

Sr. Associate - BCM - Retirement 5B

Richardson, TX · On-site +1

$74K - $91.70K/yr

... Examiner (CFE) - ACFEACFE, LOMA 280 - Principles of Insurance - GenpactGenpact, LOMA 290 ... Type - Remote Work Shift - Variable (United States of America) The approximate annual base ...

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Remote Cfe information

What are the key skills and qualifications needed to thrive as a Remote CFE (Certified Fraud Examiner), and why are they important?

To thrive as a Remote CFE, you need a solid understanding of fraud prevention, investigation techniques, and forensic accounting, typically backed by a CFE certification and a background in accounting, finance, or law enforcement. Familiarity with investigative software, data analysis tools, and remote communication platforms is commonly required. Strong analytical thinking, attention to detail, and clear written and verbal communication skills are crucial for effective collaboration and reporting. These competencies ensure thorough investigations, accurate identification of fraudulent activities, and effective remote teamwork.

What are some common challenges faced by Remote CFEs when conducting fraud examinations across different jurisdictions?

Remote Certified Fraud Examiners (CFEs) often encounter challenges related to varying legal standards and privacy regulations across jurisdictions. Gathering evidence remotely may require navigating different rules for data access and maintaining chain of custody, which calls for strong organization and attention to detail. Additionally, CFEs must be adept at using digital communication tools to collaborate with team members and clients, ensuring clear and secure information exchange. Overcoming these hurdles often involves staying updated on international compliance requirements and proactively establishing best practices for remote investigations.

What are Remote CFEs?

Remote CFEs are Certified Fraud Examiners who work from locations outside of a traditional office, typically from home or other remote settings. Their primary responsibilities include investigating fraud, conducting risk assessments, and implementing anti-fraud measures for organizations, all while utilizing digital tools to collaborate with teams and access necessary data. This role requires a strong understanding of fraud detection, forensic accounting, and legal procedures, as well as excellent communication and technical skills. Remote CFEs often work for corporations, government agencies, or as consultants to help prevent, detect, and respond to fraudulent activities.

What is the difference between Remote Cfe vs Remote Fraud Analyst?

AspectRemote CfeRemote Fraud Analyst
Required CredentialsCertified Fraud Examiner (CFE) certification, relevant finance or accounting backgroundTypically requires experience in fraud detection, sometimes certifications like CFE preferred
Work EnvironmentRemote, often in finance, legal, or compliance departmentsRemote, usually within banking, insurance, or e-commerce sectors
Industry UsageFinance, legal, corporate complianceBanking, insurance, retail, e-commerce
Common Search/ComparisonYesYes

Remote Cfe and Remote Fraud Analyst roles both focus on detecting and preventing fraud but differ in certification requirements and industry focus. Remote Cfe typically requires the CFE credential and works in compliance or legal departments, while Remote Fraud Analysts often have experience in fraud detection within banking or retail sectors. Both roles are remote and essential for fraud prevention strategies.

What states have the most Remote Cfe jobs? States with the most job openings for Remote Cfe jobs include:
Infographic showing various Remote Cfe job openings in the United States as of May 2026, with employment types broken down into 92% Full Time, and 8% Contract. Highlights an 100% Remote job distribution.
Investigator, Special Investigative Unit Coding (Remote)

Investigator, Special Investigative Unit Coding (Remote)

Molina Healthcare

Long Beach, CA • On-site, Remote

$19.64 - $42.55/hr

Full-time

Posted 22 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 191 frontline employees who took The Breakroom Quiz

145th of 259 rated insurance

Job description

Job Description
JOB DESCRIPTION
Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informational tips from member benefits and medical records following review of post-payment claims.
Essential Job Duties
  • Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies.
  • Reviews post-pay claims against corresponding medical records to determine accuracy of claims payments.
  • Manages documents and prioritizes caseloads to ensure timely turnaround.
  • Ensures adherence to applicable state/federal/internal policies, Current Procedural Terminology (CPT) guidelines and provider contract requirements.
  • Devises clinical summary post-review.
  • Communicates and participates in meetings related to cases.
  • Completes medical review to facilitate referral to law enforcement or payment recovery.
  • Supports investigation work as necessary and required by the regulatory agency.

Job Requirements
  • At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience.
  • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified
  • Critical-thinking, problem-solving and analytical skills.
  • Ability to prioritize and manage multiple tasks.
  • Ability to work in a team setting.
  • Strong verbal/written communication skills, and presentation skills.
  • Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
  • In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
  • Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations.
  • Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs.
  • Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems.
  • Ability to research and interpret regulatory requirements.

Preferred Qualifications
  • Certified Professional Compliance Officer (CPCO).
  • 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 knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.).
  • Experience with claims processing systems.
  • Ability to use Microsoft Excel/Access platforms working with large quantities of data.
  • Ability to answer questions, identify trends and patterns, and present findings.

#PJCorp
#LI-AC1
To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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