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Senior Investigator (Healthcare FWA)

Cotiviti

United States

Remote

USD 70,000 - 90,000

Full time

Yesterday

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Job summary

Cotiviti seeks a Senior Investigator to analyze and address healthcare fraud, waste, and abuse. This position involves data analysis, investigation, and working with legal personnel. Candidates should have experience and certifications in fraud investigation, along with strong skills in communication, detail orientation, and organizational ability. This full-time role includes a competitive salary and comprehensive benefits.

Benefits

Medical insurance

Dental insurance

Vision insurance

401(k) savings plan

Paid family leave

Paid Time Off (PTO)

Qualifications

Bachelor’s degree or equivalent experience required.
5-8 years of investigative experience needed.
Advanced proficiency in Excel and strong communication skills essential.

Responsibilities

Investigate instances of fraud, waste, and abuse.
Conduct interviews and analyze data to report findings.
Provide investigation-related training and support legal proceedings.

Skills

Data analysis

Excel

Verbal communication

Written communication

Attention to detail

Organizational skills

Education

Bachelor’s Degree in related discipline

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Overview

As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through

Overview

As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role .

Responsibilities

Identify, investigate, analyze and evaluate instances of potential fraud, waste, and abuse.
Conduct interviews or correspond with patients, providers, witnesses or other relevant parties to determine settlement, denial or review.
Analyze information gathered by investigation and report findings and recommendations as a written summary and/or presentation.
Conducts investigation-related training.
Supports legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions.
Negotiates settlement agreements to resolve disputes.
Maintain current knowledge of relevant laws, regulations and standards.
Participates in special projects as required.

Qualifications

Bachelor’s Degree in related discipline, or the equivalent combination of education, professional training and work experience.
5-8 years of related investigative experience.
Advanced level skills in Excel.
Excellent verbal and written communication skills.
Strong listening and observation skills.
Attention to detail and high level of accuracy.
Effective organizational and prioritization skills with multi-tasking ability.
Preferred certifications:

Accredited Healthcare Fraud Investigator (AHFI),
Certified Fraud Specialist (CFS),
Certified Fraud Examiner (CFE),
Certified Forensic Interviewer (CFI), or
Certified in Healthcare Compliance (CHC).

Job Demands

This is a work-at-home position. Access to high-speed internet is required (all other equipment will be provided).
Must be able to sit and use a computer keyboard for extended periods of time.
Travel up to 15%.
Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones.
After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent).

Mental Requirements

Communicating with others to exchange information.
Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements And Working Conditions

Remaining in a stationary position, often standing or sitting for prolonged periods.
Repeating motions that may include the wrists, hands, and/or fingers.
Must be able to provide a dedicated, secure work area.
Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Base compensation ranges from $70,000 to $90,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 6/23/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 8/23/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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Seniority level

Seniority level
Mid-Senior level

Employment type

Employment type
Full-time

Job function

Job function
Analyst
Industries
Hospitals and Health Care, Insurance, and Financial Services

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