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Remote Healthcare Fraud Investigator Jobs (NOW HIRING)

State of Georgia

$50/hr

Investigators conduct health care fraud investigations. Assists criminal justice personnel, including, but not limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud ...

State of Georgia

$70/hr

Duties & Responsibilities -Investigators conduct health care fraud investigations. -Assists criminal justice personnel, including, but not limited to, Analysts, Auditors, and Prosecutors in ...

Highmark Health

Investigator

Accredited Healthcare Fraud Investigator (AHFI) SKILLS * Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency * Must have ...

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

As of Aug 31, 2026, the average hourly pay for remote healthcare fraud 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 does a remote healthcare fraud investigator do?

A Remote Healthcare Fraud Investigator is responsible for detecting, investigating, and preventing fraudulent activities within healthcare claims and billing processes, all while working remotely. They review medical claims, analyze data, and identify patterns that may indicate fraud, abuse, or waste. Investigators often collaborate with healthcare providers, insurance companies, and law enforcement to gather evidence and resolve cases. Their work helps protect healthcare systems from financial losses and ensures compliance with regulations.

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

To thrive as a Remote Healthcare Fraud Investigator, you need a solid background in healthcare regulations, claims analysis, and investigative techniques, often supported by a degree in criminal justice, healthcare administration, or a related field. Familiarity with claims management systems, data analytics tools, and certifications such as Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE) are highly valuable. Attention to detail, critical thinking, and strong written and verbal communication skills help professionals excel in detecting and documenting fraudulent activities. These skills are essential for ensuring compliance, minimizing financial losses, and protecting the integrity of healthcare organizations.

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

Remote Healthcare Fraud Investigators often face the challenge of analyzing large volumes of complex data without in-person access to records or teams. Effective communication with healthcare providers and colleagues is crucial to overcome the lack of face-to-face collaboration. Utilizing secure digital tools for data analysis and maintaining regular virtual meetings helps ensure accuracy and efficient case resolution. Staying up-to-date with evolving healthcare regulations also helps investigators identify new fraud patterns and maintain high standards in their work.

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

AspectRemote Healthcare Fraud InvestigatorRemote Healthcare Compliance Analyst
Required CredentialsCertifications like CFE, HIPAA trainingCertifications like CHC, HIPAA compliance training
Work EnvironmentInvestigations, data analysis, auditsPolicy review, compliance monitoring, reporting
Employer & Industry UsageHealthcare providers, insurance companies, government agenciesHospitals, healthcare organizations, insurance firms

Both roles focus on healthcare regulation but differ in their primary focus. Fraud investigators concentrate on detecting and preventing fraud, while compliance analysts ensure adherence to healthcare laws and policies. Understanding these distinctions helps job seekers identify the right career path in healthcare oversight.

Are remote healthcare fraud investigators in demand?

Remote healthcare fraud investigators are in increasing demand due to the growing need to detect and prevent healthcare fraud, which results in significant financial losses for insurers and government programs. These roles often require strong analytical skills, knowledge of healthcare regulations, and experience with data analysis tools. The job outlook is positive, with opportunities expanding as healthcare organizations prioritize compliance and fraud prevention efforts.

How to become a remote healthcare fraud investigator?

To become a remote healthcare fraud investigator, candidates typically need a background in healthcare, law enforcement, or auditing, along with knowledge of healthcare billing and coding. Relevant certifications such as Certified Fraud Examiner (CFE) or Certified Healthcare Fraud Investigator (CHFI) can enhance prospects, and strong analytical skills are essential for identifying fraudulent activities. Most roles require a bachelor's degree and experience in healthcare compliance or investigations, with some positions offering remote work options.

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

A remote healthcare fraud investigator typically needs a bachelor's degree in healthcare administration, criminal justice, or a related field. Relevant experience in healthcare billing, coding, or insurance claims, along with strong analytical skills and knowledge of healthcare regulations, is also important. Certifications such as the Certified Fraud Examiner (CFE) can enhance qualifications for this role.
More about Remote Healthcare Fraud Investigator jobs

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Cities with the most Remote Healthcare Fraud Investigator job openings:

What are the most commonly searched types of Healthcare Fraud Investigator jobs?

The most popular types of Healthcare Fraud Investigator jobs are:

What states have the most Remote Healthcare Fraud Investigator jobs?

States with the most job openings for Remote Healthcare Fraud Investigator jobs include:

What job categories do people searching Remote Healthcare Fraud Investigator jobs look for?

The top searched job categories for Remote Healthcare Fraud Investigator jobs are:

Remote Healthcare Fraud Investigator jobs near you
Infographic showing various Remote Healthcare Fraud Investigator job openings in the United States as of August 2026, with employment types broken down into 96% Full Time, 2% Part Time, and 2% 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

Re-posted 18 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.

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