Senior Investigator – Healthcare FWA

Cotiviti

Senior Investigator analyzing healthcare fraud, waste, and abuse for Cotiviti’s post-pay FWA team. Conducting data-driven investigations, interviews, reporting, training, and legal support.

Posted 8/21/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $70,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in investigating healthcare fraud, waste, and abuse, with strong analytical skills to evaluate findings and communicate effectively. Proficient in conducting interviews and training, while maintaining knowledge of relevant laws and regulations.

Highest-signal resume keywords

Healthcare Fraud InvestigationAdvanced Excel SkillsExcellent Verbal and Written CommunicationAccredited Healthcare Fraud Investigator (AHFI)Certified Fraud Examiner (CFE)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Healthcare Fraud InvestigationData AnalysisReport WritingInterviewing TechniquesNegotiation SkillsRegulatory KnowledgeAttention to DetailOrganizational SkillsMulti-tasking AbilityPresentation Skills

Soft Skills

Effective CommunicationStrong Listening SkillsObservation SkillsFlexibilityTeam Collaboration

Tools & Technologies

Microsoft ExcelHigh-Speed Internet Access

Certifications & Qualifications

Accredited Healthcare Fraud Investigator (AHFI)Certified Fraud Specialist (CFS)Certified Fraud Examiner (CFE)Certified Forensic Interviewer (CFI)Certified in Healthcare Compliance (CHC)

Industry Keywords

Healthcare ComplianceFraud Waste and AbuseLegal ProceedingsSettlement AgreementsInvestigative Experience

About the role

Key responsibilities & impact

Identify, investigate, analyze and evaluate instances of potential healthcare fraud, waste, and abuse
Conduct interviews or correspond with patients, providers, witnesses, and other relevant parties to determine settlement, denial, or review
Analyze investigation information and report findings and recommendations in written summaries and/or presentations
Conduct investigation-related training
Support legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare civil or criminal cases
Negotiate settlement agreements to resolve disputes
Maintain current knowledge of relevant laws, regulations, and standards
Participate in special projects as required
Work within the post-pay Fraud Waste & Abuse team

Requirements

What you’ll need

Bachelor’s Degree in related discipline, or the equivalent combination of education, professional training and work experience
5-8 years of related investigative experience
Advanced level skills in Excel
Excellent verbal and written communication skills
Strong listening and observation skills
Attention to detail and high level of accuracy
Effective organizational and prioritization skills with multi-tasking ability
Preferred certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Specialist (CFS), Certified Fraud Examiner (CFE), Certified Forensic Interviewer (CFI), or Certified in Healthcare Compliance (CHC)
Access to high-speed internet
Ability to sit and use a computer keyboard for extended periods of time
Ability to travel up to 15%
Flexibility and willingness to participate in international work processes, including conference calls scheduled across global time zones
Flexibility to work after hours and/or weekends when necessary for major deliverables/deadlines
Ability to provide a dedicated, secure work area
Ability to provide high-speed internet access/connectivity and office setup and maintenance

Benefits

Comp & perks

Medical, dental, vision, disability, and life insurance coverage
401(k) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti
Work-at-home arrangement
High-speed internet required; all other equipment will be provided