Fraud Investigator

Peraton

. Perform entry-level fraud investigations and audits under the direct supervision of a team manager and/or team lead .

Posted 10/9/2026full-timeRemote • United StatesJuniorMid-Level💰 $39,000 - $62,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong investigative and analytical skills, with a solid understanding of healthcare regulations and compliance audits. Capable of effectively communicating findings and maintaining confidentiality while managing multiple caseloads.

Highest-signal resume keywords

Investigative ExperienceAnalytical SkillsKnowledge of Medicare and MedicaidCommunication SkillsOrganizational Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Fraud InvestigationAudit PracticesMedical ReviewClaims ReviewRegulatory InterpretationData AnalysisDocumentation SkillsCase File OrganizationOverpayment IdentificationRecord Examination

Soft Skills

Strong CommunicationTeam CollaborationAdaptabilityConfidentiality MaintenanceTactful Communication

Tools & Technologies

Data SystemsInvestigation ToolsPC Skills

Industry Keywords

Healthcare ComplianceFraud DetectionRegulatory ViolationsAdministrative ActionsLaw Enforcement Referrals

Tech Stack

Tools & technologies

React

About the role

Key responsibilities & impact

Perform entry-level fraud investigations and audits under the direct supervision of a team manager and/or team lead
Support investigations of medical professional service providers and develop cases and reports for law enforcement referrals, education, overpayment recovery and administrative actions
Work with internal resources, external agencies, state and federal investigators, and other personnel
Handle multiple caseload assignments concurrently and organize and analyze supporting information
Assist with complex reports applying regulations or rules to affected programs
Research and understand relevant offenses and conduct efficient investigations and audits
Detect or verify suspected violations through observation, record examination and interviews
Analyze investigation/audit results to determine whether allegations are corroborated and appropriate corrective actions
Prepare objective, accurate correspondence and communicate tactfully
Maintain confidentiality of health privacy information and comply with applicable laws, rules and regulations
React to unplanned situations, adjust plans and adopt effective courses of action

Requirements

What you’ll need

0 years’ experience with BS/BA, or 4 years’ experience with a HS diploma/equivalent
Investigative and analytical experience
Strong communication and organization skills
Strong PC knowledge and skills
US. citizenship required
Strong background in investigations or compliance audits (most competitive candidates)
Experience reviewing claims for technical requirements, performing medical review, and/or developing fraud cases and identifying overpayments (most competitive candidates)
Knowledge of investigative or audit practices regarding healthcare providers (most competitive candidates)
Knowledge of Medicare and/or Medicaid programs and rules, regulations, policies and procedures (most competitive candidates)
Background in evaluating, reviewing and analyzing medical claims and records (most competitive candidates)
Ability to learn and operate a variety of data systems, equipment and tools used in investigations
Ability to research and draw conclusions
Ability to document investigative/audit workload and cite regulatory violations or alleged fraud schemes
Ability to organize a case file and accurately document all steps taken
Ability to compose correspondence, reports and referral summary letters
Ability to interpret laws and regulations
Ability to handle confidential material
Ability to report work activity timely
Ability to work under direct supervision as a team member
Ability to attend meetings and training conferences

Benefits

Comp & perks

Telework available from Eastern Time Zone
Employees may be eligible for overtime
Employees may be eligible for shift differential
Employees may be eligible for a discretionary bonus
Overnight travel may be required