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Remote Nurse Fraud Jobs (NOW HIRING)

GDIT

Nurse Analyst/Investigator

WV · Remote

$93K - $126K/yr

Skills: Analytical Thinking, Clinical Review, Fraud Prevention, Medicare, Microsoft Excel ... Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our ...

Ascension

Registered Nurse Transfer Center

Milwaukee, WI · Remote

$40.41 - $57.05/hr

Remote - Must be within 1 hour of Milwaukee, WI Department: Transfer Center Schedule: Night shift ... Fraud prevention notice Prospective applicants should be vigilant against fraudulent job offers and ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an ...

Arizona Department of Administration

Auditor 3

Phoenix, AZ · On-site +1

$49K - $53K/yr

REMOTE OPTIONS, PHOENIX Categories: Accounting/Auditing, Administrative Support/Customer Service ... Calculate expenditures associated with fraud, waste and abuse to determine cost-benefit analysis ...

Briljent

Clinical Auditor - RN

Indianapolis, IN · Remote

This is a remote position with occasional travel required within Indiana. Key Responsibilities ... Knowledge of healthcare claims data and fraud, waste, and abuse preferred. Physical Requirements ...

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Remote Nurse Fraud information

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$17

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How much do remote nurse fraud jobs pay per hour?

As of Jun 22, 2026, the average hourly pay for remote nurse fraud in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What are some common challenges faced by Remote Nurse Fraud Specialists, and how can they be addressed?

Remote Nurse Fraud Specialists often encounter challenges such as identifying subtle patterns of fraudulent activity, maintaining effective communication with multidisciplinary teams, and staying updated on evolving healthcare fraud schemes. Working remotely may also make collaboration and information sharing more complex, requiring strong digital communication skills and familiarity with secure data platforms. To address these challenges, it's important to participate in ongoing training, leverage robust fraud detection software, and engage regularly in virtual meetings with colleagues in compliance, legal, and clinical departments.

What are the key skills and qualifications needed to thrive as a Remote Nurse focused on fraud detection, and why are they important?

To thrive as a Remote Nurse in fraud detection, you need a solid nursing background (RN license), strong analytical skills, and experience with healthcare compliance or claims review. Familiarity with healthcare management systems, claims processing software, and knowledge of HIPAA regulations are typically required. Attention to detail, integrity, and strong written communication are crucial soft skills for identifying discrepancies and collaborating with interdisciplinary teams. These skills ensure accurate detection of fraudulent activities, protect patient data, and help maintain the integrity of healthcare operations.

What is a Remote Nurse Fraud Investigator?

A Remote Nurse Fraud Investigator is a registered nurse who works remotely to identify, investigate, and prevent fraudulent activities related to healthcare claims and services. These professionals analyze medical records, billing information, and insurance claims to detect inconsistencies or patterns that may indicate fraud. They collaborate with insurance companies, law enforcement, and healthcare providers to gather evidence and ensure compliance with regulations. Remote Nurse Fraud Investigators play a crucial role in protecting the integrity of the healthcare system and minimizing financial losses due to fraud.

What is the difference between Remote Nurse Fraud vs Remote Medical Billing Fraud?

AspectRemote Nurse FraudRemote Medical Billing Fraud
Required CredentialsLicensed Registered Nurse (RN) or Licensed Practical Nurse (LPN)Certification in medical coding or billing, such as CPC or CCS
Work EnvironmentHealthcare facilities, telehealth platforms, or independent practiceMedical billing companies, healthcare providers, or insurance companies
Industry UsageHealthcare, telehealth, patient careHealthcare, insurance, billing services
Common Search/ComparisonRemote Nurse FraudRemote Medical Billing Fraud

Remote Nurse Fraud involves deception related to nursing credentials or patient care, while Remote Medical Billing Fraud pertains to false or inflated billing practices. Both are healthcare industry issues but differ in roles, credentials, and specific fraudulent activities.

Infographic showing various Remote Nurse Fraud job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.
Nurse Analyst/Investigator

Nurse Analyst/Investigator

GDIT

WV • Remote

$93K - $126K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

General Dynamics Information Technology rating

7.8

Company rating: 7.8 out of 10

Based on 63 frontline employees who took The Breakroom Quiz

69th of 204 rated it services

Job description

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

None

Job Family:

Process and Operational Efficiency

Job Qualifications:

Skills:

Analytical Thinking, Clinical Review, Fraud Prevention, Medicare, Microsoft Excel

Certifications:

None

Experience:

10 + years of related experience

US Citizenship Required:

No

Job Description:

We are GDIT. As one of the largest IT and mission services providers to the government, we own our opportunities to better enable healthcare organizations to identify theirs.

You can make GDIT your place. You make it your own by turning obstacles into action. By owning your opportunity at GDIT, you'll play an important role in providing the technologies and services that millions of healthcare professionals depend on, every day. Our work depends on a Nurse Analyst / Investigator joining our team to support Centers for Medicare & Medicaid Services (CMS) activities at Baltimore, Maryland.

GDIT is under contract to the Centers for Medicare & Medicaid Services (CMS) to design, develop, engineer, implement, enhance, maintain statistical algorithms to detect and prevent potential fraud, waste or abuse in the Medicare and Medicaid programs. The contract is part of the Fraud Prevention System Modeling and Analytics contract. GDIT are responsible for post-payment (models) and pre-payment (edits) identification and implementation to support the CMS' Center for Program Integrity (CPI).

At GDIT, we put our people first. As a Nurse Analyst/Investigator supporting CMS, you will be trusted to work on specific technology and data science tools to detect and prevent fraud, waste, and abuse (FWA) across the Medicare and Medicaid programs. In this role, a typical day will include:

  • Interacting with staff and leaders in the FPS program, both within GDIT and with other entities working on FPS, including business partners (e.g., system maintainer) and CMS.
  • Writing and reviewing edit proposals and consult with others regarding policy, medical coding, and clinical questions.
  • Receiving and replying to CMS urgent requests for information related to edits and other ad hoc program integrity requests.
  • Reviewing CMS policy and regulations to anchor support for new FPS edits and models.
  • Identifying new candidate topics for possible FPS edits and evaluate them by using data to identify risk and document CMS policy (e.g., LCD, NCD) that supports the edit.

.

Required Skills:

  • RNor LPN with 5+ years clinicalexperience
  • 2+years of experience in Medicare Program Integrity work at a MAC, UPIC or other program integrity contractor
  • 2+years of experience in medical coding with the corresponding appropriate professional certification(s) (e.g., CPC) or ability to attain certification within 12 months
  • Working knowledge of Medicare policy, processes and claims payment systems
  • Ability to pass CMS security clearance & background check

Desired Skills:

  • 3 years of experience interacting with and consulting with others with a different background/expertise in a team environment
  • BA/BS/BSN
  • CPC certification
  • 2+years of experience working with Medicare Fee-for-Service pre-payment edits either in FPS, FISS, MCS, and/or VMS
  • Experience with Medicaid, Medicare Part C/D
The likely salary range for this position is $93,500 - $126,500. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:

40

Travel Required:

Less than 10%

Telecommuting Options:

Remote

Work Location:

Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee's date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

Our Identity Verification Process:

As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.

About Our Work:

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.Join our Talent Community to stay up to date on our career opportunities and events at

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About General Dynamics Information Technology

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GDIT is a global technology and professional services company that delivers technology solutions and mission services to every major agency across the U.S. government, defense, and intelligence community. Its 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. The company operates across 50+ countries worldwide, offering leading capabilities in digital modernization, AI/ML, cloud, cyber, and application development.

Industry

It services

Company size

10,000+ Employees

Headquarters location

Falls Church, VA, US

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