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Remote Insurance Fraud Investigator Jobs in Washington

Fraud Management Specialist

Vienna, VA · Remote

$17.50 - $23/hr

Key skills for this role include fraud detection and investigation, data analysis, communication ... insurance, voluntary plans, as well as participation in a 401(k) plan. System One is an Equal ...

Fraud Management Specialist

Vienna, VA · Remote

$17.50 - $23/hr

Key skills for this role include fraud detection and investigation, data analysis, communication ... insurance, voluntary plans, as well as participation in a 401(k) plan. System One is an Equal ...

Fraud Management Specialist

Vienna, VA · Remote

$17.50 - $23/hr

Key skills for this role include fraud detection and investigation, data analysis, communication ... insurance, voluntary plans, as well as participation in a 401(k) plan. System One is an Equal ...

Fraud Management Specialist

Vienna, VA · Remote

$17.50 - $23/hr

Key skills for this role include fraud detection and investigation, data analysis, communication ... insurance, voluntary plans, as well as participation in a 401(k) plan. System One is an Equal ...

Senior Compliance Investigator

Fairfax, VA · On-site +1

$70K - $126K/yr

Managed care or health insurance company experience preferred. * Experience with compliance case ... Certified Fraud Examiner (CFE) preferred. * Certified Compliance & Ethics Professional (CCEP) or ...

Senior Compliance Investigator

Fairfax, VA · On-site +1

$70K - $126K/yr

Managed care or health insurance company experience preferred. * Experience with compliance case ... Certified Fraud Examiner (CFE) preferred. * Certified Compliance & Ethics Professional (CCEP) or ...

Senior Compliance Investigator

Manassas, VA · On-site +1

$70K - $126K/yr

Managed care or health insurance company experience preferred. * Experience with compliance case ... Certified Fraud Examiner (CFE) preferred. * Certified Compliance & Ethics Professional (CCEP) or ...

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Showing results 1-20

Remote Insurance Fraud Investigator information

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. Employers seek professionals skilled in data analysis, investigation techniques, and often require familiarity with fraud detection software, making this a promising field for remote work opportunities.

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 valuable.

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.

What are the most commonly searched types of Insurance Fraud Investigator jobs in Washington? The most popular types of Insurance Fraud Investigator jobs in Washington are:

Senior Healthcare Fraud Investigator / OSINT Analyst

Navanti Group

Arlington, VA • Remote

Part-time

Posted 28 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.