Fraud and Abuse Investigator / CPC - Remote
Sentara Health · United States · US
Other
Remote
physician
Pharmacist
Dentist
Demand72
Career growth66
Healthcare fit82
Remote potential92
Salary band
USD 73k – 110k
5-year outlook
Payer compliance, FWA, and coding-audit roles generally offer stable long-term demand, with advancement potential into senior investigator, coding audit, or compliance leadership roles. Exact compensation is not stated in the posting.
Clinical license
Not required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-11-09
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- physician, Pharmacist, Dentist
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering for clinicians interested in payer compliance, claims auditing, and fraud/waste/abuse work, especially those with coding or audit exposure. It is less suitable for clinicians seeking direct clinical practice or roles without claims/coding interest.
Who should apply
Nurses, pharmacists, allied health professionals, healthcare graduates, doctors, and IMGs with claims review, coding, compliance, audit, or healthcare billing exposure who want a remote payer-side role.
CV angle
Frame real clinical documentation, coding/claims review, quality/compliance, regulatory knowledge, Medicare/Medicaid exposure, data review, and provider communication as directly transferable to FWA investigations and claims audits. Do not fabricate audit or coding experience; instead highlight any concrete billing, documentation, compliance, or data-analysis work.
Skills to highlight
- Medical coding and CPC knowledge
- Claims auditing and review
- Fraud, waste, and abuse (FWA) concepts
- Healthcare compliance and regulatory knowledge
- Data analysis and statistical sampling
- Investigation documentation and report writing
- Provider/member communication
- Medicare/Medicaid and payer operations
Role summary
A remote payer compliance role investigating suspected healthcare fraud, waste, and abuse, auditing provider/pharmacy/hospital claims and coding, analyzing billing irregularities, and drafting findings or settlement recommendations for Sentara Health Plan.
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