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Remote Insurance Fraud Investigator Jobs in Missouri

Jobgether

You'll investigate suspicious activity, uncover emerging fraud patterns, and turn data insights ... Fully remote flexibility, with the option to work from an office and the opportunity to combine ...

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 ...

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 ...

Healthcare Fraud Shield

Coding Auditor

Chesterfield, MO · On-site +1

$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 ...

Alpine Intel

Fire Investigator

Kansas City, MO · Remote

Remote Schedule * Competitive Compensation Package * Bonus Opportunity * Career Growth * A Diverse ... Company Paid Life Insurance * Company Paid Short-Term and Long-Term Disability * Tuition ...

Alpine Intel

Fire Investigator

Saint Louis, MO · Remote

Remote Schedule * Competitive Compensation Package * Bonus Opportunity * Career Growth * A Diverse ... Company Paid Life Insurance * Company Paid Short-Term and Long-Term Disability * Tuition ...

Alpine Intel

Fire Investigator

Saint Joseph, MO · Remote

Remote Schedule * Competitive Compensation Package * Bonus Opportunity * Career Growth * A Diverse ... Company Paid Life Insurance * Company Paid Short-Term and Long-Term Disability * Tuition ...

Jobgether

You will help prospective customers understand how advanced fraud, risk, and compliance solutions ... You will operate in a global, remote-first environment where technical credibility, customer impact ...

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Remote Insurance Fraud Investigator information

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

AspectRemote Insurance Fraud InvestigatorRemote Insurance Claims Adjuster
Required CredentialsCertifications in fraud detection, insurance investigationsAdjuster licenses, insurance claims certifications
Work EnvironmentInvestigations, data analysis, interviewsClaims assessment, policy review, settlement processing
Employer & Industry UsageInsurance companies, fraud prevention firmsInsurance carriers, third-party claims services
Common Search & ComparisonYesYes

While both roles work within the insurance industry, Remote Insurance Fraud Investigators focus on detecting and preventing fraudulent claims through investigations and data analysis. In contrast, Remote Insurance Claims Adjusters handle the assessment and settlement of legitimate claims. Both positions require relevant certifications and are often employed remotely by insurance companies or third-party firms.

Are remote insurance fraud investigators in demand?

Remote insurance fraud investigators are in growing demand due to increased efforts to detect and prevent insurance fraud, which costs the industry billions annually. Employers seek professionals with skills in data analysis, investigation techniques, and familiarity with fraud detection tools, making this a promising field for job seekers with relevant experience and certifications. The role often offers flexible schedules and the ability to work from home, aligning with current remote work trends.

How much do remote insurance fraud investigators earn?

Remote insurance fraud investigators typically earn between $45,000 and $75,000 annually, depending on experience, location, and employer. Some roles may offer additional compensation such as bonuses or benefits, and proficiency with investigative tools and certifications can influence salary levels.

How to become a remote insurance fraud investigator?

To become a remote insurance fraud investigator, candidates typically need a background in insurance, law enforcement, or criminal justice, along with strong analytical and investigative skills. Relevant certifications such as the Certified Fraud Examiner (CFE) can enhance prospects, and proficiency with data analysis tools and remote communication platforms is often required. A bachelor's degree is commonly preferred, and experience in claims investigation or fraud detection is beneficial.

What are the most commonly searched types of Insurance Fraud Investigator jobs in Missouri?

The most popular types of Insurance Fraud Investigator jobs in Missouri are:

What are popular job titles related to Remote Insurance Fraud Investigator jobs in Missouri?

For Remote Insurance Fraud Investigator jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Remote Insurance Fraud Investigator jobs in Missouri look for?

The top searched job categories for Remote Insurance Fraud Investigator jobs in Missouri are:

What cities in Missouri are hiring for Remote Insurance Fraud Investigator jobs?

Cities in Missouri with the most Remote Insurance Fraud Investigator job openings:

Remote Insurance Fraud Investigator jobs near you
Infographic showing various Remote Insurance Fraud Investigator job openings in Missouri as of August 2026, with employment types broken down into 74% Full Time, and 26% Contract. Highlights an 100% Remote job distribution.

SIU Clinical Investigator

Healthcare Fraud Shield

Chesterfield, MO • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description

Healthcare Fraud Shield, a leader in healthcare fraud prevention and payment integrity solutions, is looking for a talented Clinical Coder/Fraud Investigator to join our team.
  • Work with SIU Team (Clinical Reviewers, CPCs, Investigators, Analysts-including performing quality check on work, assisting in research, discuss to make appropriate coding determinations as needed).
  • Analyze and interpret patient medical records pertaining to FWA investigations as needed.
  • Compare information submitted on the claims to determine the 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-9/ICD-10 from medical records as needed.
  • Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations as needed.
  • Perform data analysis of client data as needed.
  • Conduct various aspects of FWA investigations as needed.
  • Provide Subject Matter Expertise and SIU support to clients as needed.
  • Comply with Privacy and Security standards.
  • 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.
  • Other duties as needed.
  • 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:
  • Certified Professional Coder - (CPC) through governing body AAPC.
  • Minimum of one year of coding and/or billing experience is required.
  • 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.

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