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Remote Fraud Analyst Jobs (NOW HIRING)

Spokeo

Business Analyst, Payments and Fraud

Pasadena, CA · On-site +1

$103K - $132K/yr

Founded in 2006, Spokeo has built a dedicated, remote-first team with an average tenure of 6.9 ... Payments & Fraud Analytics * Support and enhance the development of payments and fraud KPIs ...

Stripe

Payments Fraud Investigator

You'll conduct deep-dive analyses of merchant accounts, lead cross-functional projects, and collaborate with stakeholders to enhance our fraud detection and prevention strategies at scale. Your ...

Zions Bank

Fraud Investigator - Remote

Midvale, UT · On-site +1

$46K - $62K/yr

We are currently seeking a Fraud Investigator to join our team. This is a remote role. What you'll ... Good analytical skills, customer service and communication skills, both verbal and written.

New

Zionsbank Corp

Fraud Investigator - Remote

Midvale, UT · Remote

$46K - $62K/yr

We are currently seeking a Fraud Investigator to join our team. This is a remote role. What you'll ... Good analytical skills, customer service and communication skills, both verbal and written.

New

ESL Federal Credit Union

Fraud Investigator

Rochester, NY · Remote

$80K - $101K/yr

This position is remote eligible for up to 40% of the time. The shift is typically Monday - Friday ... Collect and analyze evidence, document findings, and make determinations on fraudulent activities ...

Affirm

Manager, Machine Learning Engineering (Fraud)

$200K - $250K/yr

You will partner closely with Product, Fraud Analytics, Risk, and Platform teams to ensure high ... The majority of our roles are remote and you can work almost anywhere within the country of ...

Experian

This is a remote, U.S.-based individual contributor position. A successful Fraud Sales Specialist ... Analytical, problemsolving, and projectmanagement skills , with organizational discipline and ...

Experian

Fraud Sales Specialist - Remote

Charleston, WV · Remote

This is a remote, U.S.-based individual contributor position. A successful Fraud Sales Specialist ... Analytical, problem‑solving, and project‑management skills , with organizational discipline and ...

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How much do remote fraud analyst jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for remote fraud analyst in the United States is $30.68, according to ZipRecruiter salary data. Most workers in this role earn between $21.15 and $33.89 per hour, depending on experience, location, and employer.

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.

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What cities are hiring for Remote Fraud Analyst jobs? Cities with the most Remote Fraud Analyst job openings:
What are the most commonly searched types of Fraud Analyst jobs? The most popular types of Fraud Analyst jobs are:
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Remote Fraud Analyst jobs near you
Infographic showing various Remote Fraud Analyst job openings in the United States as of May 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 80% Physical, 8% Hybrid, and 12% Remote job distribution, with an average salary of $63,822 per year, or $30.7 per hour.

Clinical Auditor/Analyst (Remote)- Fraud, Waste and Abuse

UPMC Senior Communities

Pittsburgh, PA • On-site, Remote

$32.85 - $56.83/hr

Full-time

Posted 3 days ago

Job description

UPMC Health Plan has an exciting opportunity for a Clinical Auditor/Analyst position in the Fraud, Waste & Abuse department. This is a full time position working Monday through Friday daylight hours and will be a remote position.
The Clinical Auditor/Analyst is an integral part of the Special Investigations Unit (SIU) and is responsible for conducting clinical audits and reviews regarding the analysis of care and services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization. The Clinical Auditor/Analyst creates, maintains and analyzes auditing reports related to their assigned work plan and communicates the results with management. Other responsibilities include but are not limited to analysis of controlled substance prescribing and utilization to identify potential clinical care issues, prepayment review of claims, and prepayment review of unlisted codes. Claims analysis and the use of fraud and abuse detection software tools will be an integral part of the function of this position. Responsibilities will involve working in collaboration with appropriate Health Plan departments including Quality Improvement, Legal, and Medical Management to facilitate the resolution of issue or cases. Responsibilities may involve multiple line of business focused reviews, or ad hoc reviews as needed; analysis of billing by providers/physicians, and providing trending, analysis and reporting of auditing data. The Clinical Auditor/Analyst will routinely interact with providers, law enforcement and/or regulatory entities in the course of their duties.
Experience in mental health claims review and laboratory claims review is highly preferred!
Responsibilities:
  • Respond to fraud, waste, and abuse referrals and/or complete data analysis and related audits as assigned.
  • Utilize fraud detection software to assess and monitor for potential FWA.
  • Review and analyze claims, medical records and associated processes related to the appropriateness of coding, clinical care, documentation, and health plan business rules.
  • Provide a clinical opinion for special projects or various issues including appropriate utilization of controlled substances, prescribing of controlled substances, or medically appropriate services.
  • Query medical and/or pharmacy claims and conduct a risk assessment by performing data analysis and applying applicable coding guidelines,
  • Health Plan policies and any applicable National Coverage Determination (NCD) or Local Coverage Determination (LCD).Evaluate referrals from Pharmacy Benefit Manager (PBM) by analyzing medical and pharmacy claims and associated clinical documentation in HealthPlaNET, Mars, Epic and/or Cerner.
  • Complete audits by utilizing standard coding guidelines and principles and coding clinics to verify that the appropriate CPT codes/DRGs were assigned and supported in the medical record documentation.
  • Attend in person or virtual recipient restriction hearings.
  • Review Medical Pended Queue claims to understand and resolve claim referral issues through research and interaction with other Health Plan Departments including Medical Management, Medical Directors, various committees, and other appropriate Health Plan departments.
  • As necessary, assist in the development of new policies concerning future Health Plan payment of identified issue.
  • Assess, investigate and resolve low to intermediate issues.
  • Write concise written reports including statistical data for communication to other areas of UPMC Health Plan and to communicate with department heads for identification of various problem issues, how they affect the Health Plan, and to make recommendations for resolution of the issue.
  • Identify error trends to determine appropriate training needs and suggest modifications to company policies and procedures.
  • Conduct provider education, as necessary, regarding audit results.
  • Communicate effectively with Medical Directors and ancillary departments as necessary to address issues and concerns.
  • Understand customers including internal Health Plan Departments (i.e. Claims staff, Customer Service, Marketing, etc.) and external customers (i.e. Health System Internal Audit, Client Audit teams) to understand issues, identify solutions and facilitate resolution.
  • Serve as an SIU representative at internal and external meetings, document and present findings to SIU Staff and document as appropriate in the SIU FWA Case Management Database.
  • Assist in the development and revision of SIU policies and procedures.
  • Identify trends for improvements internally, such as claims payment, to determine appropriate training needs and suggest modification to company policies and procedures.
  • Participate in training programs to develop a thorough understanding of the materials presented.
  • Obtain CPE or CEUs to maintain nursing license, and/or professional designations.
  • Design and maintain reports, auditing tools and related documentation.
  • Maintain or exceed designated quality and production goals.
  • Maintain employee/insured confidentiality and adhere to HIPAA regulations.

Qualifications:
  • Registered Nurse (RN).
  • Five years of clinical experience.
  • Two years of fraud & abuse, auditing, case management, quality review or chart auditing experience required.
  • Ability to analyze data, maintain designated production standards, and organize multiple projects and tasks.
  • In-depth knowledge of medical terminology, ICD-10 and CPT-4 coding. Knowledge of health insurance products and various lines of business.
  • Detail-oriented individual with excellent organizational skills.
  • Keyboard dexterity and accuracy.
  • High level of oral and written communication skills.
  • Proficiency with Microsoft Office products (Excel, Access, OneDrive, OneNote and Word).
    Licensure, Certifications, and Clearances:
    AAPC or AHIMA Certified (CPC, CPMA, CIC, CCA, CCS, CCS-P) or AHFI designation preferred.
  • Registered Nurse (RN)

*Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.
UPMC is an Equal Opportunity Employer/Disability/Veteran

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