Fraud and Waste Investigator

Humana

Fraud and Waste Investigator at Humana analyzing healthcare fraud allegations and coordinating investigations. Preparing evidence and audit reports with a focus on billing practices.

Posted 7/13/2026full-timeRemote • Kentucky, Ohio • 🇺🇸 United StatesMid-LevelSenior💰 $65,000 - $88,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in healthcare fraud investigations and auditing, with a strong understanding of healthcare payment methodologies and the ability to prepare complex reports. Possesses strong organizational, interpersonal, and communication skills to effectively coordinate with law enforcement and analyze data.

Highest-signal resume keywords

Healthcare Fraud InvestigationsAuditing ExperienceHealthcare Payment MethodologiesData AnalysisReport Preparation

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Fraud InvestigationAudit ReportingData AnalysisBilling Practices ReviewEvidence Assembly

Soft Skills

Organizational SkillsInterpersonal SkillsCommunication SkillsInquisitive NatureStrong Ethics

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft Access

Industry Keywords

HealthcareFraud PreventionBilling PracticesLaw Enforcement CoordinationAdjudication Support

About the role

Key responsibilities & impact

Conduct investigations of allegations of fraudulent and abusive practices
Coordinate investigation with law enforcement authorities
Assemble evidence and documentation to support successful adjudication
Conduct on-site audits of provider records ensuring appropriateness of billing practices
Prepare complex investigative and audit reports
Understand department, segment, and organizational strategy and operating objectives
Make decisions regarding own work methods, occasionally in ambiguous situations

Requirements

What you’ll need

At least 3 years of healthcare fraud investigations and/or auditing experience
Knowledge of healthcare payment methodologies
Strong organizational, interpersonal, and communication skills
Inquisitive nature with ability to analyze data to metrics
Computer literate (MS, Word, Excel, Access)
Strong personal and professional ethics.

Benefits

Comp & perks

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
short-term and long-term disability
life insurance