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Remote Fraud Jobs in Reston, VA (NOW HIRING)

Manulife

Senior Underwriting Consultant

Washington, DC · Remote

$111K - $131K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... Review underwriting fraud referrals for appropriateness and assist management with book of business ...

10a Labs

Research Fellow

Washington, DC · On-site +1

$32.50/hr

Work on sensitive topics (e.g. hate, violence, scams and fraud, etc.) with professionalism and care ... Comfort working independently and collaboratively in a remote setting. * Basic scripting skills (e ...

Booz Allen Hamilton, Inc.

TAK Developer

Manassas, VA · On-site +1

$86K - $198K/yr

Remote Work: Yes Job Number: R0241546 Location: Manassas,VA,US Share job via: Share TAK Developer ... We reserve the right to take your picture to verify your identity and prevent fraud. Candidate AI ...

Aerotek

Java Developer

Rockville, MD · On-site +1

$12 - $123/hr

Experience with fraud detection and AML systems. * Strong problem-solving and analytical skills ... remote position. Application Deadline This position is anticipated to close on Jun 13, 2026. About ...

Ferguson Enterprises, LLC

IT Auditor

Springfield, VA · On-site +1

This role is approved to be fully remote and can be based anywhere in the United States. This role ... Recognizes the role of the internal audit function in fraud risk management, prevention, and ...

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All JobsRemote Fraud JobsRemote Fraud Jobs in Reston, VA

Remote Fraud information

See Reston, VA salary details

$16

$31

$66

How much do remote fraud jobs pay per hour?

As of Jun 22, 2026, the average hourly pay for remote fraud in Reston, VA is $31.92, according to ZipRecruiter salary data. Most workers in this role earn between $22.02 and $35.24 per hour, depending on experience, location, and employer.

What are some common challenges faced by professionals working in remote fraud detection roles?

Professionals in remote fraud detection roles often face challenges such as staying updated on rapidly evolving fraud tactics and maintaining effective communication with team members across different locations. Working remotely can require extra diligence in accessing secure systems and handling sensitive data safely. Additionally, collaborating with cross-functional teams such as IT, legal, and customer support is crucial to investigate and resolve complex fraud cases efficiently. Staying proactive and adaptable is key to success in a fast-paced, ever-changing fraud landscape.

What are the key skills and qualifications needed to thrive as a Remote Fraud Analyst, and why are they important?

To thrive as a Remote Fraud Analyst, you need strong analytical skills, attention to detail, and a background in finance, business, or a related field. Familiarity with fraud detection software, data analysis tools, and relevant certifications such as Certified Fraud Examiner (CFE) are commonly required. Excellent problem-solving, communication, and decision-making abilities set top performers apart in this position. These skills are crucial for accurately identifying fraudulent activity, minimizing financial risk, and ensuring organizational security in a remote work environment.

What Are Remote Jobs in Fraud Investigations?

A fraud investigation service investigates potential instances of fraud, most typically as related to insurance or financial fraud. Fraud investigation services employ professionals with various roles, each with their own duties and responsibilities. For example, as a remote investigator, you work from home to collect evidence to determine whether or not the subject of the investigation committed fraud. Your duties include documenting your findings for potential civil or criminal litigation. Fraud investigation services sometimes employ remote customer service representatives whose responsibilities involve gathering information relevant to the fraud complaint from customers and updating them on the progress of their case.

What are remote fraud jobs?

Remote fraud jobs involve working from a location outside of a traditional office to detect, investigate, and prevent fraudulent activities in various industries such as banking, e-commerce, and insurance. Professionals in these roles use digital tools and data analysis to identify suspicious transactions, review customer activity, and protect organizations from financial losses. They may also collaborate with law enforcement and other departments to respond to incidents of fraud. Remote fraud specialists must have strong analytical skills, attention to detail, and knowledge of cybersecurity or financial regulations.

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

AspectRemote FraudRemote Fraud Analyst
CredentialsTypically requires knowledge of fraud prevention, certifications like CFE or CFCS beneficialRequires similar certifications, often with experience in fraud detection and analysis
Work EnvironmentRemote, often part of a fraud prevention or security team within a companyRemote, usually within a security or risk management department
Industry UsageUsed broadly across finance, e-commerce, banking, and insurance sectorsCommonly found in finance, banking, and online retail industries

Remote Fraud refers to the broader role of preventing and managing fraud remotely across various industries. Remote Fraud Analyst is a specific position focused on analyzing fraud cases, detecting patterns, and implementing prevention strategies. While both roles require similar skills and certifications, the Fraud Analyst typically performs detailed investigations and analysis, whereas Remote Fraud may encompass broader responsibilities in fraud prevention strategies.

More about Remote Fraud jobs
What are the most commonly searched types of Fraud jobs in Reston, VA? The most popular types of Fraud jobs in Reston, VA are:
What are popular job titles related to Remote Fraud jobs in Reston, VA? For Remote Fraud jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Remote Fraud jobs in Reston, VA look for? The top searched job categories for Remote Fraud jobs in Reston, VA are:
What cities near Reston, VA are hiring for Remote Fraud jobs? Cities near Reston, VA with the most Remote Fraud job openings:
Remote Fraud jobs near you
SIU Nurse Auditor, RN, CPC (Full-time, Remote)

SIU Nurse Auditor, RN, CPC (Full-time, Remote)

Integrity Management Services, Inc.

Alexandria, VA • Remote

Full-time

Posted 17 days ago

Job description

Job Title: Clinical Nurse Auditor – Payment Integrity

Job Summary
We are seeking an experienced Clinical Nurse Auditor to join our Payment Integrity team. In this role, you will leverage your clinical expertise, medical coding proficiency, and auditing skills to identify, monitor, and analyze unusual utilization patterns and potential fraud by healthcare providers. You will conduct prepayment claims reviews, post-payment audits, and comprehensive provider record reviews to ensure accurate billing, compliance with payer regulations, and integrity in reimbursement practices. This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified Professional Coder), CIC (Certified Inpatient Coder), CDI (Clinical Documentation Improvement), or a similar credential, through AAPC or AHIMA. Knowledge of commercial insurance plans, Medicare, and Medicaid programs is essential.

How You Will Make an Impact

  • Investigations and Audits: Conduct in-depth medical reviews through prepayment claims review and post-payment auditing to identify potential over-utilization or fraudulent activities.
  • Tool and Policy Development: Assist in the creation of audit tools, policies, procedures, and educational materials to enhance audit effectiveness and maintain high standards in payment integrity.
  • Cross-Departmental Collaboration: Serve as a liaison with service operations and other departments to provide status updates on claims reviews and coordinate actions as needed.
  • Data Analysis and Trending: Analyze performance data to identify patterns and trends, collaborate with service operations to address process improvements, and recommend modifications to medical policy.
  • Fraud Detection Support: Support fraud investigators with medical review expertise to detect and address fraudulent activities.
  • Mentorship: Act as a resource and mentor to other nurse auditors, supporting their professional growth and development in audit practices.

Requirements

Qualifications

  • Education:
    • Minimum Associate’s Degree in Nursing required;
  • Licensure & Certification:
    • Current, unrestricted Registered Nurse (RN) license in applicable state(s).
    • Certification in medical coding from AAPC or AHIMA (e.g., CPC, CIC, CDI, or equivalent) is highly preferred.
  • Experience:
    • Minimum 5 years of clinical nursing experience, preferably with exposure to hospital bill auditing or defense auditing.
    • Strong knowledge of provider manuals, reimbursement policies, and medical policy guidelines.
    • Prior experience with healthcare fraud investigation and auditing is highly preferred.
  • Skills:
    • Proficiency in CPT/HCPCS and ICD-10 coding, with a strong foundation in auditing, accounting, and control principles.
    • Analytical and problem-solving skills with a keen attention to detail.
    • Exceptional written and verbal communication skills for clear and effective reporting and provider engagement.
    • Strong proficiency in Microsoft Office and familiarity with audit tracking systems.

Preferred Traits

  • Meticulous, organized, and objective in analyzing claims and documentation.
  • Ethical and responsible, with a commitment to supporting the integrity of healthcare billing and reimbursement.
  • Able to work independently, stay current with rapidly changing healthcare regulations, and thrive in a fast-paced environment.