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Remote Healthcare Fraud Investigator Jobs (NOW HIRING)

Healthcare Fraud Shield

Coding Auditor

Chesterfield, MO · Remote

$27 - $30.75/hr

Under direct supervision of Healthcare Fraud Shield SIU management, this position executes routine ... Minimum of one year of investigative experience is required. * Required to have one of the ...

Peerspace

Associate Investigator, Trust and Safety

$26/hr

We believe that a healthy company culture creates an environment where people are excited to come ... Review sign-up, login, and transaction fraud triggers, identifying and blocking fraudulent platform ...

Rate

Fraud Risk Analyst

$60K/yr

Training will be provided via remote access as well. Responsibilities include but are not limited ... , healthcare and/or dependent day care flexible spending accounts); life insurance and death ...

S3 Shared Services

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 ...

Xtream Adminz

Remote Healthcare Recruiter

Gulfport, MS · Remote

We are also open to welcoming new recruiters who may not have experience in healthcare recruiting but have experience in other related fields such as sales. JOB RESPONSIBILITIES: * Interacting with ...

Sierra Forensic Group (SFG)

Associate

Miami, FL · On-site +1

Remote About Sierra Forensic Group Sierra Forensic Group (SFG) is a boutique forensic accounting ... fraud, health care fraud, purchase price disputes, royalty audit, related party transactions ...

S3 Shared Services

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 ...

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

As of Aug 11, 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.

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 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 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.

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.

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, making them valuable in the evolving healthcare compliance landscape.
More about Remote Healthcare Fraud Investigator jobs
What cities are hiring for Remote Healthcare Fraud Investigator jobs? 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:
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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 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $64,132 per year, or $30.8 per hour.

Coding Auditor

Healthcare Fraud Shield

Chesterfield, MO • Remote

$27 - $30.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Job description

Description
The Coding Auditor is a professional auditing role designed for a certified professional coder. Under direct supervision of Healthcare Fraud Shield SIU management, this position executes routine coding reviews to ensure health records align accurately with billed ICD-10-CM, CPT, HCPCS, Revenue codes. The ideal candidate has a strong foundation in primary medical coding and a keen eye for detail, eager to learn complex audit frameworks, regulatory policies, and documentation validation.

Key Responsibilities
  • Compare the procedures and codes billed on a claim to a medical record.
  •  Compare information submitted on the claims in order to determine amount and nature of billable services as needed.
  • Determines appropriateness of billing and reimbursement as needed.
  • Documents findings for each claim line in a spreadsheet as needed.
  • Summarize findings in a written report as needed.
  • Abstracts CPT, HCPCS, Revenue Codes, DRG codes, and ICD-10 from medical records as needed.
  • Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations as needed.
  • Understands and complies with all company Privacy and Security standards.
  •  Employee may not use or disclose any protected health information, except as otherwise permitted, or required, by law.
  • On average, there are a minimum of 5-10 claim line reviews per hour.
  • Other duties as needed.

Skills, Knowledge and Expertise
  • Knowledge of medical terminology.
  • Knowledge of coding including CPT, HCPCS, Revenue Codes, DRG Codes, and ICD-10.
  • Knowledge of specialty medical practices.
  • Must be detail oriented.
  • Ability to communicate effectively both verbally and in writing.
  • Strong listening skills.
  • Independent. 
  • Responsible.
  • Self-disciplined.
  • Ability to meet defined performance and production goals.
  • Strong computer skills.
  • This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

Certificate/License:
  • Minimum of one year of investigative experience is required.
  • Required to have one of the following: CPC, CCS, CCA

Benefits
  • Medical, Dental & Vision insurance
  • 401(k) retirement savings with employer match
  • Vacation and sick paid time off
  • 7 paid holidays & 2 floating holidays
  • Paid maternity/paternity leave
  • Disability & Life insurance
  • Flexible Spending Account (FSA)
  • Employee Assistance Program (EAP)
  • Professional and career development initiatives
  • Remote work eligible


REMOTE WORK REQUIREMENTS:
  • Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.


Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.