Senior Investigator (Healthcare Fraud, Waste & Abuse)

Location: Remote within the United States; work-from-home position with up to 15% travel and participation in calls across global time zones.

Base compensation: $70,000–$90,000 per year.

Company

hirify.global provides healthcare-related analytics and fraud, waste, and abuse solutions.

What you will do

• Identify, investigate, analyze, and evaluate potential healthcare fraud, waste, abuse, and non-compliance.
• Monitor provider activity and use claims data, dashboards, predictive models, and industry intelligence to detect anomalies and emerging patterns.
• Apply data mining, sampling, and extrapolation methods to support post-pay investigations.
• Prepare written summaries, presentations, findings, and recommendations.
• Conduct investigation-related training and support civil or criminal proceedings, including testimony and coordination with law enforcement.
• Maintain knowledge of relevant laws, regulations, and standards while contributing to special projects.

Requirements

• Bachelor’s degree in a related discipline, or an equivalent combination of education, professional training, and experience.
• 5–8 years of related fraud, waste, and abuse investigative experience.
• Advanced Excel skills and experience with proactive data mining.
• Experience with sampling and data extrapolation; RAT-STATS experience is preferred.
• Strong verbal and written communication, listening, observation, organization, prioritization, and multitasking skills.
• Must provide a dedicated, secure work area and high-speed internet for remote work.

Nice to have

• Experience with hirify.global FWA tools such as Sentinel, Commander, or Informant.
• AHFI, CFS, CFE, CFI, or CHC certification.

Culture & Benefits

• Work-from-home arrangement with company-provided equipment other than high-speed internet.
• Medical, dental, vision, disability, and life insurance coverage.
• 401(k) savings plan and paid family leave.
• 9 paid holidays and 17–27 days of paid time off, depending on level and length of service.
• Occasional after-hours or weekend work may be required for major deliverables and deadlines.