Review medically complex claims , pre-authorization requests, appeals, and fraud/abuse referrals ... Strong analytical, organizational, and decision-making skills . * Ability to work independently ...
Review medically complex claims , pre-authorization requests, appeals, and fraud/abuse referrals ... Strong analytical, organizational, and decision-making skills . * Ability to work independently ...
Senior Analyst
$87K - $116K/yr
Location: Remote allowed but hybrid based in one NV5's Offices Geospatial Offices preferred ... Conduct complex geospatial analyses using transportation-related data sources, including roadway ...
Senior Analyst
$87K - $116K/yr
Location: Remote allowed but hybrid based in one NV5's Offices Geospatial Offices preferred ... Conduct complex geospatial analyses using transportation-related data sources, including roadway ...
Remote Business Analyst (VA ESOM)
$120K - $130K/yr
Kentro is hiring for a remote Business Analyst to support our Veterans Affairs ESOM contract. The Business Analyst supports transition activities for the CMDB and Change Control workstreams by ...
Remote Business Analyst (VA ESOM)
$120K - $130K/yr
Kentro is hiring for a remote Business Analyst to support our Veterans Affairs ESOM contract. The Business Analyst supports transition activities for the CMDB and Change Control workstreams by ...
Review medically complex claims , pre-authorization requests, appeals, and fraud/abuse referrals ... Strong analytical, organizational, and decision-making skills . * Ability to work independently ...
Review medically complex claims , pre-authorization requests, appeals, and fraud/abuse referrals ... Strong analytical, organizational, and decision-making skills . * Ability to work independently ...
You will focus on helping our clients' Anti-Fraud, Claims and Underwriting departments with advice ... Ability to analyze raw data and KPIs to extract actionable insights and inform decisions PREFERRED ...
You will focus on helping our clients' Anti-Fraud, Claims and Underwriting departments with advice ... Ability to analyze raw data and KPIs to extract actionable insights and inform decisions PREFERRED ...
Contracting & Credentialing Manager - Full Time - Remote
OR · Remote
$90K - $115K/yr
... and fraud resolution, and so much more. * Flexibility - Experity is committed to helping team ... Manage multiple tasks, analyze complex issues, and implement effective solutions. * Other duties as ...
Contracting & Credentialing Manager - Full Time - Remote
OR · Remote
$90K - $115K/yr
... and fraud resolution, and so much more. * Flexibility - Experity is committed to helping team ... Manage multiple tasks, analyze complex issues, and implement effective solutions. * Other duties as ...
Senior Technical Support Engineer
OR · On-site +1
$120K - $160K/yr
Transmit Security is a leader in identity and fraud prevention, empowering organizations to stop ... You'll be expected to perform in-depth root cause analyses, manage critical incidents, and ...
Senior Technical Support Engineer
OR · On-site +1
$120K - $160K/yr
Transmit Security is a leader in identity and fraud prevention, empowering organizations to stop ... You'll be expected to perform in-depth root cause analyses, manage critical incidents, and ...
Marketing Technology Product Analyst - CRM, Marketing Cloud - NO 3rd party candidates
OR · On-site +1
Remote / flexible location * Collaborative team environment * Works closely with solution leads and ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
Marketing Technology Product Analyst - CRM, Marketing Cloud - NO 3rd party candidates
OR · On-site +1
Remote / flexible location * Collaborative team environment * Works closely with solution leads and ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
No 3rd party candidates will be considered This is a REMOTE, contract role with our fortune 100 ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
No 3rd party candidates will be considered This is a REMOTE, contract role with our fortune 100 ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
No 3rd party candidates will be considered This is a REMOTE, contract role with our fortune 100 ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
Quick apply
No 3rd party candidates will be considered This is a REMOTE, contract role with our fortune 100 ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
No 3rd party candidates will be considered This is a REMOTE, contract role with our fortune 100 ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
No 3rd party candidates will be considered This is a REMOTE, contract role with our fortune 100 ... Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake ...
Senior Commercial Exchange Analyst
OR · On-site +1
$87K - $116K/yr
This role is highly analytical and business-facing: you will extract signals from noisy auction ... We are a remote-first company with US hubs in Redwood City, Los Angeles, and New York City. Travel ...
Senior Commercial Exchange Analyst
OR · On-site +1
$87K - $116K/yr
This role is highly analytical and business-facing: you will extract signals from noisy auction ... We are a remote-first company with US hubs in Redwood City, Los Angeles, and New York City. Travel ...
Senior Underwriting Consultant
OR · Remote
$98K - $116K/yr
This is a remote role open to any location in continental US Manulife is a leading international ... The incumbent will analyze decisions without compromising overall underwriting policies and should ...
Senior Underwriting Consultant
OR · Remote
$98K - $116K/yr
This is a remote role open to any location in continental US Manulife is a leading international ... The incumbent will analyze decisions without compromising overall underwriting policies and should ...
Treasury Associate
OR · Remote
$65K - $71K/yr
At OneSpan, we specialize in digital identity and anti-fraud solutions that create exceptional and ... This is a full-time remote position; however, candidates must be based within the New England area ...
Quick apply
Treasury Associate
OR · Remote
$65K - $71K/yr
At OneSpan, we specialize in digital identity and anti-fraud solutions that create exceptional and ... This is a full-time remote position; however, candidates must be based within the New England area ...
AML Investigator
$65/hr
Treliant is hiring experienced AML/BSA Analysts and Investigators for project-based client engagements. All work will be 100% remote. Responsibilities While the scope of each project may be different ...
AML Investigator
$65/hr
Treliant is hiring experienced AML/BSA Analysts and Investigators for project-based client engagements. All work will be 100% remote. Responsibilities While the scope of each project may be different ...
Compliance Analyst
OR · Remote
Compliance Analyst Location: United States ... Remote (EST or CST preferred) Experience: Associate Level Job Function : Compliance Employment Type ...
Compliance Analyst
OR · Remote
Compliance Analyst Location: United States ... Remote (EST or CST preferred) Experience: Associate Level Job Function : Compliance Employment Type ...
Research Analyst
OR · On-site +1
This is a remote-friendly opportunity that can sit in NYC, one of our office hubs, or anywhere else ... As A Research Analyst, Your Key Responsibilities Will Include: * Data Driven Research : Create and ...
Research Analyst
OR · On-site +1
This is a remote-friendly opportunity that can sit in NYC, one of our office hubs, or anywhere else ... As A Research Analyst, Your Key Responsibilities Will Include: * Data Driven Research : Create and ...
Underwriter
OR · Remote
Remote "Indecomm is an Equal Employment Opportunity Employer" : The underwriter will review ... address fraud alerts Analyze derogatory credit, including but not limited to collections ...
Underwriter
OR · Remote
Remote "Indecomm is an Equal Employment Opportunity Employer" : The underwriter will review ... address fraud alerts Analyze derogatory credit, including but not limited to collections ...
Remote "Indecomm is an Equal Employment Opportunity Employer" :The underwriter will review ... Verify all loan term obligations were considered to qualifyThoroughly analyze the credit report for ...
Remote "Indecomm is an Equal Employment Opportunity Employer" :The underwriter will review ... Verify all loan term obligations were considered to qualifyThoroughly analyze the credit report for ...
Remote Financial Analyst - AI Trainer ($50-$60 per hour)
Keizer, OR · Remote
$50 - $60/hr
Enjoy the flexibility of remote work and the freedom to set your own schedule. This is an ... Proficient in financial analysis, financial modeling, data analysis, and other reasoning exercises ...
Remote Financial Analyst - AI Trainer ($50-$60 per hour)
Keizer, OR · Remote
$50 - $60/hr
Enjoy the flexibility of remote work and the freedom to set your own schedule. This is an ... Proficient in financial analysis, financial modeling, data analysis, and other reasoning exercises ...
Remote Fraud Analyst information
See Oregon salary details
$16.52 - $21.14
15% of jobs
$22.81 is the 25th percentile. Wages below this are outliers.
$21.14 - $25.76
28% of jobs
The median wage is $27.43 / hr.
$25.76 - $30.38
19% of jobs
$34.16 is the 75th percentile. Wages above this are outliers.
$30.38 - $35
16% of jobs
$35 - $39.63
12% of jobs
$39.63 - $44.25
3% of jobs
$44.25 - $48.87
1% of jobs
$48.87 - $53.49
3% of jobs
$53.49 - $58.11
0% of jobs
$58.11 - $62.73
3% of jobs
$62.73 - $67.35
0% of jobs
$16
$32
$67
How much do remote fraud analyst jobs pay per hour?
What are the key skills and qualifications needed to thrive in the Remote Fraud Analyst position, and why are they important?
To thrive as a Remote Fraud Analyst, you need strong analytical abilities, attention to detail, and a background in finance, business, or a related field. Familiarity with fraud detection software, data analysis tools like Excel or SQL, and relevant certifications such as CFE (Certified Fraud Examiner) are common requirements. Excellent communication skills, critical thinking, and the ability to work independently are valuable soft skills for this position. These skills are crucial for quickly identifying suspicious activities and effectively collaborating with cross-functional teams to mitigate risks.
What are some typical challenges faced by Remote Fraud Analysts, and how can they overcome them?
Remote Fraud Analysts often face challenges such as staying up to date with evolving fraud techniques, managing large volumes of transaction data, and effectively communicating findings with distributed teams. To overcome these challenges, it’s important to continuously participate in relevant training, leverage advanced analytical tools, and establish clear protocols for virtual collaboration. Many companies provide strong support structures, ongoing professional development, and access to collaborative platforms to help analysts excel in their roles. Being proactive in learning and maintaining open, timely communication ensures success and impactful contributions to a remote fraud prevention team.
What is a Remote Fraud Analyst job?
A Remote Fraud Analyst is responsible for detecting and preventing fraudulent activities by analyzing transactions, user behavior, and financial data from a remote location. They use fraud detection tools, risk assessment techniques, and company policies to identify suspicious activity and take necessary actions. Their role often involves reviewing flagged transactions, investigating fraud cases, and working with other teams to implement fraud prevention strategies. Strong analytical skills, attention to detail, and knowledge of fraud detection systems are essential for this position.
Job description
Job Type: Full-time (40 hours/week)
Schedule: Monday-Friday, 8:00 AM - 5:00 PM
Max Salary: W-2 ($65,000/$31.25)
Location: Remote (U.S. - Work from home)
Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office
Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.
We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.
Key Responsibilities- Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
- Assess payment determinations using clinical information and established guidelines.
- Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
- Provide clear, well-documented rationales for service approvals or denials.
- Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
- Support quality control activities to meet corporate and team objectives.
- Provide guidance to LPN team members and support non-clinical staff through training and discussions.
- Assist with special projects and additional responsibilities as assigned.
- Active, unrestricted RN license in the U.S. and in the state of hire
OR - Active compact multistate RN license (as defined by the Nurse Licensure Compact).
- Associate Degree in Nursing
OR - Graduate of an accredited School of Nursing.
- Two years of clinical experience plus at least two years in one of the following:
- Home Health
- Utilization/Medical Review
- Quality Assurance
- Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
- Ability to interpret and apply medical review criteria and clinical guidelines.
- Proficiency in Microsoft Office and word processing software.
- Strong analytical, organizational, and decision-making skills.
- Ability to work independently while managing priorities effectively.
- Excellent customer service, communication, and critical thinking skills.
- Ability to handle confidential information with discretion.
- Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred).
- Proficiency in using multiple screens and software programs simultaneously.
If you are a detail-oriented RN with a passion for medical review, we encourage you to apply!
About BROADWAY VENTURES
Sourced by ZipRecruiter
Industry
Business management consulting
Company size
11 - 50 Employees
Headquarters location
Canton, MS, US
Year founded
2013