Senior Investigator, Healthcare FWA

Cotiviti

. Identify, investigate, analyze and evaluate potential healthcare fraud, waste, and abuse .

Posted 11/4/2026full-timeRemote • United StatesSenior💰 $74,000 - $91,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in investigating healthcare fraud, waste, and abuse, with strong analytical skills to evaluate findings and communicate effectively. Proficient in conducting interviews and training, while maintaining knowledge of relevant laws and regulations.

Highest-signal resume keywords

Healthcare Fraud InvestigationAdvanced Excel SkillsEffective Communication SkillsAttention to DetailAccredited Healthcare Fraud Investigator (AHFI)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Investigative AnalysisReport WritingNegotiation SkillsTraining DeliveryLegal Support

Soft Skills

Listening SkillsOrganizational SkillsPrioritization SkillsMulti-tasking Ability

Tools & Technologies

High-Speed Internet Access

Certifications & Qualifications

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

Industry Keywords

Healthcare ComplianceFraud Waste & AbuseLegal ProceedingsCivil CasesCriminal Cases

About the role

Key responsibilities & impact

Identify, investigate, analyze and evaluate potential healthcare fraud, waste, and abuse
Conduct interviews or correspond with patients, providers, witnesses, and other relevant parties to determine settlement, denial, or review
Analyze investigative information and report findings and recommendations in written summaries and/or presentations
Conduct investigation-related training
Support legal proceedings, including testifying in court or working with law enforcement to prepare civil or criminal cases
Negotiate settlement agreements to resolve disputes
Maintain current knowledge of relevant laws, regulations, and standards
Participate in special projects as required
Work within the post-pay Fraud Waste & Abuse team

Requirements

What you’ll need

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)
Access to high-speed internet
Ability to sit and use a computer keyboard for extended periods
Willingness to travel up to 15%
Flexibility and willingness to participate in international work processes and conference calls across global time zones
Ability to work after hours and/or weekends when necessary for major deliverables/deadlines
Ability to provide a dedicated, secure work area
Ability to provide high-speed internet access/connectivity and office setup and maintenance

Benefits

Comp & perks

Medical, dental, vision, disability, and life insurance coverage
401(k) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti
Work-at-home arrangement
High-speed internet access required; all other equipment will be provided