Peraton · 15 hours ago
Fraud Investigator
United States
Full-time
Remote
Entry, Mid Level
$51K/yr - $82K/yr
2+ years expPeraton is a next-generation national security company that drives missions of consequence spanning the globe. They are seeking a Fraud Investigator to perform complex investigations of medical professional service providers and develop cases for future action, including referrals to law enforcement and other administrative actions.
Information TechnologyRobotics
No H1B
U.S. Citizen Only
Responsibilities
Performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse in Medicare and Medicaid programs
An investigator uses good judgment and may work independently with minimum supervision and direction
The investigator also may work as part of a team as there may be times when the investigator needs to work with state and/or federal investigators and other personnel
An investigator handles multiple caseload assignments concurrently; organizes and analyzes complex evidentiary patterns; interviews and obtains statements from witnesses and others
Investigators may also be required to complete complex investigative reports that apply regulations or rules to the program(s) affected by the behavior being investigated
There may also be times when the investigator will need to apply federal or state laws
Investigators are expected to research and understand the relevant offenses being investigated; conduct efficient and effective investigations concerning those alleged offenses and detect or verify suspected violations; obtain information and evidence by observation, record examination, and interview
Investigators then analyze the results of the investigation to ascertain if the allegations have been corroborated and work with others to determine the appropriate steps that need to be taken to address the issues
As part of an investigation, the investigator will need to prepare correspondence; be objective and accurate and communicate with others with tact
There may be times when investigators need to react to unplanned situations, be flexible in planning their activities and adopt effective courses of action
As investigators will be working with health privacy information, they also must maintain confidentiality and understand all the laws, rules and regulations concerning health privacy
Qualification
Required
4 years with AS/AA; 2 years with BS/BA; 6 years with High School diploma
2 years investigative experience
Knowledge of Medicare and/or Medicaid programs and the rules, regulations, policies and procedures
Knowledge and experience in the healthcare industry
Strong investigative skills
Strong communication and organization skills
Strong PC knowledge and skills
US citizenship is required
Telework available from Maine, New Hampshire, Vermont, New York, Rhode Island, Connecticut, Massachusetts, Pennsylvania, Delaware, District of Columbia, New Jersey, Maryland, Northern Virginia
Preferred
Strong background in investigations
Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
Knowledge of investigative practices regarding healthcare providers
Background in evaluating, reviewing and analyzing medical claims and records
Ability to learn and operate a variety of data systems, equipment and tools used in investigations
Benefits
Medical
Dental
Vision
Life
Health savings account
Short/long term disability
EAP
Parental leave
401(k)
Paid time off (PTO) for vacation
Company paid holidays
Company
Peraton
Peraton Fearlessly solving the toughest national security challenges.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Thomas Terjesen
Chief Information Officer
Recent News
Washington Technology
2026-01-22
2025-09-25
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