Fraud Investigator Associate

Peraton

. Perform entry-level fraud investigation and audit work under direct supervision of a team manager or team lead .

Posted 10/16/2026full-timeRemote • United StatesJuniorMid-Level💰 $39,000 - $62,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong investigative and analytical skills, with the ability to conduct thorough audits and research within healthcare compliance. Proficient in documenting findings and communicating effectively with various stakeholders while maintaining confidentiality and adhering to regulations.

Highest-signal resume keywords

Investigative ExperienceAnalytical SkillsKnowledge Of Medicare And Medicaid ProgramsStrong Communication SkillsOrganizational Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Fraud InvestigationAudit PracticesMedical ReviewClaims ReviewRegulatory ComplianceData AnalysisReport WritingRecord ExaminationObservation TechniquesCase Documentation

Soft Skills

Effective CommunicationTeam CollaborationTactful InteractionConfidentiality MaintenanceTime Management

Tools & Technologies

Data SystemsInvestigation ToolsPC Knowledge

Industry Keywords

Healthcare ComplianceFraud DetectionOverpayment RecoveryInvestigative PracticesAdministrative Actions

About the role

Key responsibilities & impact

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

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 preferred for competitive candidates
Experience reviewing claims for technical requirements, performing medical review, and/or developing fraud cases and identifying overpayments
Knowledge of investigative or audit practices regarding healthcare providers
Knowledge of Medicare and/or Medicaid programs and related rules, regulations, policies and procedures
Background evaluating, reviewing and analyzing medical claims and records
Ability to learn and operate data systems, equipment and tools used in investigations
Ability to perform research and draw conclusions
Ability to document investigative/audit information and identify regulatory violations or alleged fraud schemes
Ability to organize case files and accurately document all steps taken
Ability to compose correspondence, reports and referral summary letters
Ability to educate providers, provider associations, law enforcement, contractors and beneficiary advocacy groups
Ability to communicate effectively internally and externally
Ability to interpret laws and regulations
Ability to handle confidential material
Ability to report work activity in a timely manner
Ability to work under direct supervision as part of a team
Ability to attend meetings and training conferences; overnight travel may be required

Benefits

Comp & perks

Telework available from the NE UPIC jurisdiction
Overtime eligibility may apply
Shift differential may apply
Discretionary bonus may be available
Attendance at training conferences
Overnight travel opportunities/requirements