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Remote Fraud Nurse Investigator Jobs (NOW HIRING)

Fraud Analyst

Englewood, CO · Remote

$52K - $60K/yr

Fraud Analyst - Remote / Colorado Applicants only Salary range: $52,000 to $60,000 annually The ... Monitor alerts and communications from various sources to identify and investigate suspicious ...

Fraud Analyst

Englewood, CO · Remote

$52K - $60K/yr

Fraud Analyst - Remote / Colorado Applicants only Salary range: $52,000 to $60,000 annually The ... Investigate complex fraud cases. * Mentor Associate Fraud Analysts through their investigations ...

Provide investigative and anti-fraud advisory services across specialty and standard commercial ... MS #LI-REMOTE What C&F will bring to you * Competitive compensation package * Generous 401K ...

Provide investigative and anti-fraud advisory services across specialty and standard commercial ... MS #LI-REMOTE What C&F will bring to you * Competitive compensation package * Generous 401K ...

Provide investigative and anti-fraud advisory services across specialty and standard commercial ... LI-REMOTE * Competitive compensation package * Generous 401K employer match * Employee Stock ...

Provide investigative and anti-fraud advisory services across specialty and standard commercial ... MS #LI-REMOTE What C&F will bring to you * Competitive compensation package * Generous 401K ...

We are a remote first company. This role, as most of our positions, is remote. You may be required ... investigations. Additionally, the Fraud Analyst will ensure that all cases of suspicious or ...

Training will be provided via remote access as well. Responsibilities include but are not limited ... Document investigative efforts in compliance with internal policy and regulatory requirements.

Remote within the United States, preferably residing in New Hampshire Responsibilities: * Ensures compliance with all requirements related to Special Investigation Units and fraud, waste and abuse ...

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Remote Fraud Nurse Investigator information

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How much do remote fraud nurse investigator jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for remote fraud nurse investigator in the United States is $30.83, according to ZipRecruiter salary data. Most workers in this role earn between $22.12 and $35.34 per hour, depending on experience, location, and employer.

What are some common challenges faced by remote fraud nurse investigators, and how can they be addressed?

Remote Fraud Nurse Investigators often encounter challenges such as limited access to in-person medical records, difficulty verifying the authenticity of claims, and navigating complex healthcare regulations across different states. To overcome these obstacles, strong analytical skills, attention to detail, and proficiency with digital investigation tools are essential. Regular communication with colleagues and claims professionals, as well as ongoing training in emerging fraud schemes, can help ensure accurate assessments and effective teamwork even in a remote setting.

What are the key skills and qualifications needed to thrive as a remote fraud nurse investigator?

To thrive as a Remote Fraud Nurse Investigator, you need a strong clinical background, experience in medical claims review, and an active RN license. Familiarity with medical coding systems, healthcare claims software, and investigative tools such as SIU platforms is typically required. Critical thinking, attention to detail, and strong written communication skills are essential soft skills in this role. These competencies enable accurate detection and reporting of fraudulent activity, ensuring compliance and protecting healthcare resources.

What is the difference between Remote Fraud Nurse Investigator vs Remote Insurance Claims Nurse?

AspectRemote Fraud Nurse InvestigatorRemote Insurance Claims Nurse
CertificationsRN license, fraud investigation trainingRN license, claims processing certification
Work EnvironmentInvestigating fraud cases, analyzing claimsReviewing insurance claims, assessing validity
Employer & IndustryInsurance companies, healthcare fraud unitsInsurance providers, healthcare organizations
Search & Comparison IntentFraud detection, investigation rolesClaims review, insurance nurse roles

Remote Fraud Nurse Investigators focus on detecting and investigating insurance fraud, requiring specialized training in fraud detection. Remote Insurance Claims Nurses primarily review and process insurance claims, ensuring accuracy and compliance. While both roles require nursing credentials and work within the insurance industry, their core responsibilities differ—investigation versus claims processing.

What is a remote fraud nurse investigator?

A Remote Fraud Nurse Investigator is a registered nurse who works remotely to identify, investigate, and help prevent healthcare fraud, waste, and abuse. They review medical claims, patient records, and provider billing practices to detect discrepancies or suspicious activities that may indicate fraudulent behavior. Their work often involves collaborating with insurance companies, law enforcement, and healthcare providers to ensure compliance with regulations and protect patients and payers from fraud. Remote roles allow these professionals to conduct investigations, interviews, and audits using secure digital platforms. This position requires strong analytical, clinical, and investigative skills.
More about Remote Fraud Nurse Investigator jobs
What cities are hiring for Remote Fraud Nurse Investigator jobs? Cities with the most Remote Fraud Nurse Investigator job openings:
What are the most commonly searched types of Fraud Nurse Investigator jobs? The most popular types of Fraud Nurse Investigator jobs are:
What states have the most Remote Fraud Nurse Investigator jobs? States with the most job openings for Remote Fraud Nurse Investigator jobs include:
Infographic showing various Remote Fraud Nurse Investigator job openings in the United States as of August 2026, with employment types broken down into 90% Full Time, 5% Part Time, and 5% Contract. Highlights an 100% Remote job distribution, with an average salary of $64,132 per year, or $30.8 per hour.

Senior Healthcare Fraud Investigator / OSINT Analyst

Navanti Group

Arlington, VA • Remote

Part-time

Posted 28 days ago


Job description

Senior Healthcare Fraud Investigator / OSINT Analyst


Company: Navanti Group, LLC
Location: Remote
Employment Type: Part-Time / Consultant
Security Clearance: Active Top Secret clearance required at time of application
Estimated Level of Effort: Approximately 1015 hours per week on average, with workload varying based on investigative tasking. The position is anticipated to support approximately 550650 hours annually; no minimum number of hours is guaranteed.

Position Overview
Navanti Group is seeking a senior healthcare fraud investigator and Open-Source Intelligence analyst to support a sensitive federal law-enforcement customer. This individual will serve as the primary technical lead for healthcare fraud-related OSINT research, analysis, and reporting.
The selected candidate will support federal criminal, civil, administrative, and parallel healthcare fraud investigations by identifying publicly available information, relationships, assets, digital activity, business affiliations, and potential indicators of fraudulent conduct. The position requires an uncommon combination of direct healthcare fraud investigative experience, advanced OSINT expertise, federal investigative experience, and an active Top Secret clearance.
Primary Responsibilities

  • Conduct complex OSINT research concerning individuals, healthcare providers, businesses, affiliated entities, assets, ownership structures, and associated networks.
  • Identify and analyze online presence, business relationships, professional affiliations, financial indicators, and other publicly available information relevant to investigative objectives.
  • Conduct link, relationship, and network analysis to identify connections among subjects, providers, businesses, beneficiaries, and associated entities.
  • Apply healthcare fraud expertise to develop investigative leads involving:
    • Medicare and Medicaid fraud
    • Home health agency fraud
    • Durable medical equipment fraud
    • Hospice fraud
    • Provider enrollment and ownership-concealment schemes
    • Kickbacks and patient brokering
    • Billing irregularities and related fraud typologies
  • Translate OSINT findings into actionable healthcare fraud investigative value.
  • Monitor publicly available sources relevant to active and proactive investigations.
  • Prepare clearly sourced investigative summaries, intelligence products, link analyses, and rapid-turn responses.
  • Document research sources, methodologies, limitations, and analytical confidence.
  • Ensure findings are suitable for investigative, operational, administrative, and potential legal review.
  • Support authorized sensitive operational activities, including limited OSINT assistance related to undercover or covert investigative efforts.
  • Coordinate with Navantis Program Manager and Quality Manager to ensure deliverables meet customer requirements.


Mandatory Qualifications

  • Minimum of five years of specialized experience supporting civil or criminal healthcare fraud investigations.
  • Minimum of ten years of experience providing OSINT or investigative support to federal government agencies, the Intelligence Community, or law-enforcement organizations.
  • Demonstrated experience conducting advanced OSINT investigations and intelligence analysis.
  • Experience supporting sensitive or complex federal investigations.
  • Working knowledge of Medicare and Medicaid programs.
  • Familiarity with common and emerging healthcare fraud schemes across multiple provider types.
  • Experience supporting civil, criminal, administrative, or parallel investigative proceedings.
  • Familiarity with federal investigative standards, evidentiary considerations, documentation practices, and reporting requirements.
  • Ability to produce defensible, clearly sourced, and analytically sound investigative products.
  • Demonstrated discretion, sound professional judgment, and a security-conscious operational posture.


Preferred Qualifications

  • Prior experience supporting an Office of Inspector General, Department of Justice, federal healthcare law-enforcement organization, or federal investigative agency.
  • Experience with provider ownership research, corporate records, asset identification, public-record databases, social-media analysis, and digital-presence assessment.
  • Experience using network-analysis and social-media intelligence platforms.
  • Experience with link-analysis tools and preparation of visual network products.
  • Experience supporting protective intelligence, undercover operations, or sensitive online investigative activities.
  • Formal training in OSINT tradecraft, fraud investigations, financial investigations, intelligence analysis, criminal justice, or a related discipline.


Availability and Performance Requirements
The selected candidate must generally be available during federal business hours, Monday through Friday, between 8:00 a.m. and 6:00 p.m. Eastern Time. The individual must be able to acknowledge and begin assigned tasking within eight business hours and provide limited after-hours support for priority investigative requirements when necessary. The position is fully remote, and no routine travel is anticipated. Planned periods of unavailability must be communicated in advance to support continuity of operations.
Reporting Structure
The Senior Healthcare Fraud Investigator / OSINT Analyst will report administratively to Navantis Program Manager. Investigative priorities, technical direction, reporting standards, and task deadlines will be established by the authorized federal customer representative.