Join the Mission to Outwit Fraud—From Anywhere!

Our Origin Story: A Vision Fueled by Integrity

Once upon a brainstorm, our team envisioned a future where healthcare was transparent, equitable, and safe from deception. From that spark, we grew into a powerhouse of innovation, rooted in trust, fueled by data, and driven by a deep respect for providers and patients. Today, we empower remote professionals nationwide to safeguard healthcare systems, one claim at a time.

Key Responsibilities of a Remote Health Insurance Fraud Investigator

Detect and Dismantle Fraudulent Activities

Scour digital trails, identify suspicious activity, and pinpoint patterns that scream "something's off." Your investigations will expose inconsistencies in medical billing, claim documentation, and provider practices.

Build Robust Fraud Investigation Cases

Compile robust, evidence-backed reports. Think timelines, claim audits, coding validation, and statements wrapped in logical storytelling.

Collaborate Across Departments

Team up with compliance analysts, legal advisors, and medical experts to create airtight strategies that hold water—and hold wrongdoers accountable.

Communicate Effectively and Professionally

Interview providers and policyholders (remotely, of course), approach sensitive conversations with poise, and translate complex fraud cases into understandable language for non-technical stakeholders.

Stay Informed and Adaptive

Keep tabs on evolving fraud trends, regulatory changes, and industry technologies. Innovation is your sidekick.

Remote Work Environment and Flexibility

Work-from-Home Setup

This role is 100% remote, meaning you’ll be sleuthing from the comfort of your workspace—be it a sunlit kitchen nook, quiet library corner, or converted garage lab. Wherever you are, our team is only a Zoom away. You’ll enjoy the independence of remote work with the full backing of a collaborative, supportive network.

Tools and Technology You Will Use

• Advanced fraud detection software
• Electronic Health Records (EHR)
• Data analytics platforms
• Secure video conferencing tools
• CRM and investigative case management systems

Qualifications and Ideal Candidate Profile

Required Experience and Skills

• A background in health insurance claims, coding, or clinical review (3+ years preferred)
• Firm grasp of ICD-10, CPT, and HCPCS coding
• Experience with FWA (Fraud, Waste, and Abuse) investigations
• Comfortable dissecting large data sets to derive actionable insights
• Exceptional attention to detail and analytical thinking
• Natural communicator with solid report-writing chops
• Independent, proactive, and loves the thrill of a challenge

Preferred Qualifications

• Certifications like CFE (Certified Fraud Examiner) or AHFI (Accredited Health Fraud Investigator)
• Experience in remote fraud analytics or work-from-home fraud investigator roles

Salary and Benefits Overview

• Annual Salary: $64,132
• Flexible Hours: Because brilliant minds aren’t 9-to-5
• Remote Setup: Includes tech reimbursement
• Professional Development: Ongoing learning and certification support
• Recognition: Digital awards and peer recognition programs

Career Growth and Advancement Opportunities

We don't believe in static roles. Start as a fraud investigator, become a compliance leader, a fraud intelligence strategist, or even an internal policy architect. Your ambition writes your future here. We offer structured mentorships, cross-functional project access, and a fast track for leadership development. We value creativity and reward curiosity—our next innovation could come from your fresh idea.

Company Culture and Team Dynamics

We’re not your typical corporate labyrinth. We’re thinkers, doers, and game-changers. You’ll work alongside a wildly imaginative, genuinely kind team that celebrates creativity, questions the status quo, and thrives on intellectual curiosity. We like to say: “Come for the mission, stay for the memes."

Testimonials from Our Team

"Every day is different, and every case feels like a real-life puzzle. There's something incredibly satisfying about following the breadcrumbs and protecting patients. Plus, working from home means I can chase fraud and still make it to school pickup."

Call to Action: Apply to Become Our Next Fraud-Fighting Hero

We thought so. If you’ve got an eye for detail, a thirst for justice, and a knack for storytelling through data, then you’ve just found your tribe.

Apply Today. Decode Tomorrow.