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Remote Fraud Investigator Jobs in Ridgewood, NJ (NOW HIRING)

Oscar Health

Clinical Investigator

New York, NY · On-site +1

$67K - $89K/yr

This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois ... Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an ...

Turing

Remote Retail Private Investigator

Manhattan, NY · Remote

$100 - $150/hr

Turing is looking for candidates with strong experience in retail loss prevention, fraud detection ... Design and solve real-world retail investigation and loss prevention scenarios to test AI reasoning.

Till Financial

Fraud Analyst

Brooklyn, NY · Remote

Investigate fraud alerts generated by internal rules engines and third-party tools (e.g. Sift ... Remote-first, NYC preferred for occasional in-person collaboration Logistics Till is an equal ...

Till Financial

Fraud Analyst

Brooklyn, NY · On-site +1

$70K - $105K/yr

Investigate fraud alerts generated by internal rules engines and third-party tools (e.g. Sift ... Remote-first, NYC preferred for occasional in-person collaboration Logistics Till is an equal ...

Allstate

SIU Field Investigator

Bronx, NY · On-site +1

$68K - $104K/yr

Reviews investigations with fraud outcomes to validate whether denial is appropriate * Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to ...

Efi global

Fire Investigator

New York, NY · On-site +1

... fraud and arson cases and providing expert witness testimony, into a recognized global leader in ... a fulltime, remote role . This position is ideal for a selfdirected professional who values ...

Delta Group

SIU Investigator - Newark, NJ

Newark, NJ · Remote

$30 - $40/hr

... state fraud prosecutorial offices, claims and program management divisions, and investigative ... operations. For over 41 years, our investigative resources have helped organizations reduce risk ...

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Remote Fraud Investigator information

See Ridgewood, NJ salary details

$15

$31

$53

How much do remote fraud investigator jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for remote fraud investigator in Ridgewood, NJ is $31.20, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.77 per hour, depending on experience, location, and employer.

What is a remote fraud investigator?

A Remote Fraud Investigator is a professional who investigates fraudulent activities, such as financial fraud, identity theft, or cybercrime, while working from a remote location. They analyze data, review transactions, and gather evidence to identify and prevent fraudulent behavior. These investigators often work for banks, insurance companies, government agencies, or private organizations. Their work may involve interviewing witnesses, collaborating with law enforcement, and preparing reports to support legal action. The remote aspect allows them to conduct their duties using digital tools and secure communication platforms.

What does a remote fraud investigator do?

The primary job duties of a remote fraud investigator involve finding instances of fraud and collecting evidence about each case. In this job, you work from home or otherwise remotely to investigate fraud in the insurance industry, with credit cards, and in other financial services sectors. Depending on the case, you may review records of transactions, perform research related to the finances or actions or a suspect, and interview witnesses. When investigating mail fraud, you often work with members of the post office. In general, you work remotely and/or at investigation sites and then compile a report on your findings for business or legal action.

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

To thrive as a Remote Fraud Investigator, you need strong analytical abilities, attention to detail, and a background in finance, criminal justice, or a related field. Familiarity with fraud detection software, case management systems, and relevant certifications such as CFE (Certified Fraud Examiner) are highly valuable. Excellent communication, critical thinking, and the ability to work independently are essential soft skills for this role. These competencies are crucial for accurately identifying fraudulent activity, efficiently managing cases remotely, and effectively collaborating with teams and stakeholders.

How do remote fraud investigators typically collaborate with colleagues and other departments while working offsite?

Remote Fraud Investigators often collaborate closely with colleagues in compliance, risk management, and customer service teams through secure digital communication platforms. They participate in regular video meetings, share case updates via internal systems, and often work on joint investigations with other investigators or analysts. Effective communication skills and timely documentation are essential to ensure everyone stays aligned on case progress and regulatory requirements. Building strong virtual relationships helps maintain a coordinated approach to detecting and preventing fraudulent activities.

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

AspectRemote Fraud InvestigatorRemote Fraud Analyst
CredentialsTypically requires certifications like ACFE or CFE, relevant experienceOften requires similar certifications, focus on data analysis skills
Work EnvironmentRemote, investigative setting, collaborating with law enforcement or financial institutionsRemote, data-driven environment, analyzing transactions and patterns
Employer & IndustryFinancial institutions, e-commerce, insurance companiesFinancial services, banking, e-commerce
Search & Comparison IntentFocus on investigation, case management, and fraud detectionFocus on analyzing data, identifying fraud patterns

Remote Fraud Investigators and Remote Fraud Analysts share similar credentials and work environments, often within financial or e-commerce sectors. Investigators focus on active case resolution and law enforcement collaboration, while Analysts primarily analyze data to identify fraud trends. Both roles are essential for combating fraud remotely, but their daily tasks and focus areas differ slightly.

Are remote fraud investigators in demand?

Remote fraud investigators are in high demand due to increasing online transactions and financial crimes. Employers seek professionals skilled in fraud detection, data analysis, and using tools like fraud management software, with many roles offering flexible remote work options.

What qualifications do you need to be a remote fraud investigator?

A remote fraud investigator typically needs a bachelor's degree in criminal justice, finance, or a related field. Relevant skills include attention to detail, analytical thinking, and experience with fraud detection tools or software. Certifications such as Certified Fraud Examiner (CFE) can enhance qualifications, and strong communication skills are also important for reporting findings.
More about Remote Fraud Investigator jobs

What cities near Ridgewood, NJ are hiring for Remote Fraud Investigator jobs?

Cities near Ridgewood, NJ with the most Remote Fraud Investigator job openings:

Remote Fraud Investigator jobs near you
Infographic showing various Remote Fraud Investigator job openings in Ridgewood, NJ as of August 2026, with employment types broken down into 86% Full Time, 10% Part Time, 2% Temporary, and 2% Contract. Highlights an 100% Remote job distribution, with an average salary of $64,888 per year, or $31.2 per hour.

Investigator, Special Investigative Unit Coding (Remote)

New York, NY • Remote

Molina Healthcare
Health Care and Social Assistance • 10K+ employees

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

171st of 315 rated insurance

People enjoy working here

Good employer

Recommended by students

Learn more about Molina Healthcareexternal

Full-time

Posted 5 days ago

Job description

JOB DESCRIPTION
Provides 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, 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 of 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.
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.
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).
 

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 platform and work with large quantities of data.
Ability to answer questions, identify trends and patterns, and present findings."
 

 
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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