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Remote Fraud Jobs in Worcester, MA (NOW HIRING)

Dyne Therapeutics

Director, Compliance

Waltham, MA · Remote

... care fraud and abuse laws, Value & Access matters, patient support programs, data privacy, and ... This role is based in Waltham, MA, without the possibility of being a remote role. Primary ...

ASCENSUS

Senior Associate General Counsel

Newton, MA · Remote

$140/hr

Desire to work in a fast-paced and demanding enviro environment For all virtual remote positions ... Be aware of employment fraud. All email communications from Ascensus or its hiring managers ...

UnitedHealth Group

Customer Service Representative

Auburn, MA · Remote

$16 - $21.75/hr

This position is Remote in Auburn, MA. You will have the flexibility to work remotely* as you take on some tough challenges. Explore opportunities with Atrius Health, part of the Optum family of ...

All JobsFraud JobsRemote Fraud JobsRemote Fraud Jobs in Worcester, MA

Remote Fraud information

See Worcester, MA salary details

$15

$30

$63

How much do remote fraud jobs pay per hour?

As of Jul 31, 2026, the average hourly pay for remote fraud in Worcester, MA is $30.62, according to ZipRecruiter salary data. Most workers in this role earn between $21.11 and $33.80 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 Worcester, MA? The most popular types of Fraud jobs in Worcester, MA are:
What job categories do people searching Remote Fraud jobs in Worcester, MA look for? The top searched job categories for Remote Fraud jobs in Worcester, MA are:
What cities near Worcester, MA are hiring for Remote Fraud jobs? Cities near Worcester, MA with the most Remote Fraud job openings:
Remote Fraud jobs near you
Infographic showing various Remote Fraud job openings in Worcester, MA as of July 2026, with employment types broken down into 2% As Needed, 74% Full Time, 22% Part Time, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $63,684 per year, or $30.6 per hour.

Medical Program Auditor/ Analyst

University of Massachusetts Medical School

Westborough, MA • On-site, Remote

$80K - $95K/yr

Full-time

Re-posted 9 hours ago

Job description

Under the general direction of the Associate Director or designee, the Fraud, Waste, and Abuse (FWA) Auditor serves a crucial role in identifying, investigating, and preventing fraud, waste and abuse for Medicaid programs. A major function of this position is to conduct desk and onsite audits across various provider types to ensure compliance with federal and state regulations. The Auditor performs investigative activities to develop leads and detect aberrant billing practices, including data mining, claims analysis, and medical record assessment.

Onsite requirement 1-2 times per month, all other aspects of the job are remote.


Responsibilities:

  • Ensure compliance with federal and state regulations and healthcare FWA industry standards.
  • Perform independent data mining and data analysis utilizing claims data to detect patterns and trends that may uncover fraud, waste, or non-compliant billing practices.
  • Conduct onsite audits as required, to assess the completeness of medical and administrative records and the compliance with applicable regulatory requirements.
  • Prepare detailed audit documentation, summaries of investigative findings, compile case files, calculate sanctions and overpayments based on violations cited.
  • Communicate with providers regarding issues such as general regulatory compliance, audit findings, and the recovery process.
  • Recommend policy, procedure and system changes to enhance investigative outcomes.
  • Update appropriate internal management staff regularly on progress of investigations.
  • Stay current with regulatory updates, coding changes, and industry standards.
  • Identify trends from national fraud-related publications and recommend new or improved strategies to strengthen fraud-detection efforts.
  • Assist with document management, updating case-tracking system and adhering to record retention policies and procedures.
  • Perform other duties as assigned.

Qualifications:

  • Bachelor's degree in business, health care administration, or other related field
  • 4-6 years of related experience in the healthcare industry, business,; with at least two years of experience conducting data mining in the healthcare insurance industry, healthcare claim audits, administrative medical record reviews or other claims analysis related experience
  • Knowledge of CPT, HCPCS and ICD-10 coding, reimbursement and claims processing policies
  • Strong analytical and qualitative skills as well as problem solving skills with the ability to look for root causes and implement workable solutions
  • Ability to interpret and apply law and regulations as it relates to fraud and fraud investigations
  • Ability to multi-task, establish priorities and work independently and collaboratively to achieve audit objectives
  • Proficiency in Microsoft Office applications (Word, Excel, PowerPoint and Access)
  • Excellent Customer service skills with the ability to interact professionally and effectively with providers, clients, and internal stakeholders from all departments
  • Ability to travel within Massachusetts and be on-site as needed for audits

Preferred Qualifications:

Prefer individual possessing any of the following certifications or licensure: CPC or CPMA
Knowledge of state and federal regulations as they apply to public assistance programs

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