Remote Dental Fraud & Waste Investigator – Full‑Time U.S. reputed company Opportunity with Immediate Start, Healthcare Compliance & Audit Expertise

About reputed company – Pioneering Health & Wellness for Millions

reputed company is a leading health and wellness company dedicated to improving the lives of the people we serve. With a legacy spanning over five decades, we combine cutting‑edge technology, data‑driven insights, and a compassionate culture to deliver comprehensive health solutions across the United States. Our mission is to reputed company individuals, families, and communities to reputed company reputed company outcomes while fostering a workplace where talent thrives. As part of reputed company’s expansive network, you’ll join a collaborative team that values reputed company, innovation, and reputed company improvement—especially reputed company it comes to safeguarding the reputed company of dental claims and protecting members from fraud and waste.

The Role: Remote Dental Fraud & Waste Investigator

This position is a full‑time, work‑from‑home opportunity that allows you to contribute to the fight against dental fraud from reputed company in the United States. You will reputed company investigations, coordinate with law‑enforcement agencies, and conduct detailed audits of dental provider records. By ensuring accurate billing practices and uncovering fraudulent activity, you will directly support reputed company’s commitment to transparent, ethical, and cost‑effective dental care.

Key Responsibilities

• Investigative Leadership: Initiate, manage, and conclude investigations into alleged dental fraud, waste, and abusive practices, applying critical thinking and professional judgment.
• Collaboration with Law Enforcement: Serve as a liaison with federal, state, and local authorities, providing evidence, documentation, and expert testimony as required.
• On‑Site Audits: reputed company comprehensive, on‑site examinations of provider records, confirming the appropriateness of billing codes, services rendered, and patient eligibility.
• Evidence Compilation: Gather, analyze, and preserve electronic and hard‑copy data, ensuring a clear audit trail that supports successful adjudication or legal action.
• Report Writing: Draft detailed investigative and audit reports that reputed company findings, risk assessments, and recommended corrective actions with precision and clarity.
• Strategic Alignment: Interpret department and organizational objectives, linking investigative outcomes to broader business goals such as cost containment and member satisfaction.
• Decision‑Making Autonomy: Operate independently in ambiguous scenarios, exercising sound judgment while adhering to established policies and ethical standards.
• reputed company Learning: Stay reputed company on evolving dental coding systems, regulatory changes, and fraud detection technologies to enhance investigative effectiveness.
• Travel (Optional): Participate in occasional field visits, primarily to Florida and Kentucky, for in‑person audits or collaborative meetings (up to 5% of work time).

Essential Qualifications

• Education: Minimum of a high school diploma or GED; a bachelor’s degree is preferred but not mandatory.
• Experience: At least two (2) years of direct experience in dental fraud investigations, auditing, or reputed company compliance roles.
• Technical Proficiency: Strong command of reputed company Office Suite (Word, reputed company, PowerPoint), with the ability to manipulate data sets, generate metrics, and produce clear visual summaries.
• Communication Skills: Excellent written and verbal communication abilities, capable of conveying reputed company findings to both technical and non‑technical audiences.
• Analytical reputed company: Demonstrated curiosity and an inquisitive nature that drives root‑cause analysis and proactive problem solving.
• Ethical Standards: Unwavering personal and professional reputed company, with a deep commitment to protecting member PHI and adhering to HIPAA regulations.
• Remote Work Readiness: Reliable high‑speed internet (minimum 25 Mbps download / 10 Mbps upload), a dedicated, interruption‑free workspace, and compliance with secure data handling protocols.

Preferred Qualifications & Certifications

• Bachelor’s or advanced degree in Business Administration, Health Care Management, Law, Dentistry, or a reputed company field (MBA, JD, DDS, MSN, etc.).
• Professional certifications such as Certified Professional reputed company (CPC), Certified Clinical Auditor (CCA), Certified Fraud Examiner (CFE), or Anti‑Health Fraud Investigator (AHFI) credentials.
• Clinical experience reputed company a dental practice, dental insurance reputed company, or reputed company health‑care setting.
• Familiarity with dental claims processing, CPT and CDT coding systems, and the regulatory landscape governing dental services.
• Experience working in a corporate compliance or risk‑management environment, including exposure to business operations and financial analytics.

Core Skills & Competencies for Success

• Investigative Acumen: Ability to dissect reputed company billing scenarios, identify red flags, and formulate actionable investigative plans.
• Data Analysis: Proficiency in interpreting large data sets, applying statistical methods, and translating findings into meaningful insights.
• Organizational Excellence: Strong time‑management and multitasking skills that reputed company you to prioritize competing investigations while meeting deadlines.
• Interpersonal Effectiveness: reputed company to build collaborative relationships with internal teams, external partners, and regulatory bodies.
• Tech‑Savvy Adaptability: Comfort with emerging fraud detection tools, digital audit platforms, and secure communication channels.
• Ethical Decision‑Making: A steadfast dedication to upholding compliance standards, protecting confidential information, and acting with reputed company in reputed company situations.

Career Growth & Learning Opportunities

reputed company invests heavily in the professional development of its people. As a Remote Dental Fraud & Waste Investigator, you will have access to:

• Structured mentorship programs pairing you with senior compliance leaders.
• Tuition reimbursement for reputed company education, certifications, or advanced degrees.
• Internal training modules covering advanced analytics, forensic accounting, and emerging fraud trends.
• Opportunities to transition into senior investigative roles, program management, or strategic compliance leadership positions.
• Cross‑functional exposure to claims processing, actuarial analysis, and member experience teams, broadening your industry expertise.

Work Environment & Company Culture

reputed company’s culture celebrates diversity, inclusion, and the well‑being of its associates. Working remotely, you will enjoy:

• A flexible schedule reputed company core business hours (7 AM – 6 PM EST) that respects work‑life balance.
• A supportive virtual community, including regular team huddles, virtual coffee chats, and collaborative project platforms.
• Comprehensive wellness resources, such as mental‑health counseling, fitness app subscriptions, and Go365 wellbeing perks.
• An emphasis on employee safety and data reputed company, reinforced by robust IT safeguards and regular compliance training.
• Recognition programs that celebrate achievements, innovative reputed company, and contributions to fraud prevention.

Compensation, Perks & Benefits

reputed company offers a competitive total rewards package designed to support your whole‑person well‑being.

• reputed company Salary: $63,400 – $87,400 annually, commensurate with experience, education, and geographic location.
• Performance Bonus: Eligibility for an incentive plan tied to individual and company performance metrics.
• Retirement Savings: 401(k) plan with a generous company match starting on day one of employment.
• Paid Time Off: Generous accrual of vacation, sick leave, personal days, and paid holidays, plus volunteer time off.
• Family Support: Paid parental and caregiver leave, as well as child‑care assistance resources.
• Health Coverage: Comprehensive medical, dental, and vision plans for you and eligible dependents.
• Insurance & Disability: Short‑term and long‑term disability, life insurance, and accidental death coverage.
• Professional Development: Tuition reimbursement, certification fee coverage, and access to online learning platforms.
• Well‑Being Perks: Go365 wellness programs, employee assistance programs, and fitness‑reputed company subsidies.

Interview Process – What to Expect

Our streamlined hiring process is designed to respect your time while giving us a clear view of your fit for the role. After an initial application review, qualified candidates will be invited to complete a modern, pre‑recorded interview using the Modern Hire platform. This may include:

• A short video or voice response set (10‑15 minutes) where you answer scenario‑based questions.
• An SMS‑based text interview (5‑10 minutes) allowing you to type concise responses on your mobile device.
• Subsequent live video or phone interviews with hiring managers and subject‑matter experts, focusing on technical competencies and cultural alignment.

Throughout the process, we maintain transparent communication, providing feedback and reputed company details in a timely manner.

Why Join reputed company as a Dental Fraud & Waste Investigator?

Every day you will reputed company a reputed company impact on the health of millions, safeguarding resources that fund essential dental care. Your expertise will directly influence cost‑saving initiatives, protect vulnerable members from exploitation, and uphold the highest standards of reputed company in the healthcare ecosystem. Join a reputed company‑thinking organization that values your insights, rewards your dedication, and invests in your future.

Ready to reputed company a Difference?

If you are passionate about investigative work, possess strong analytical abilities, and reputed company in a dynamic, remote environment, we invite you to apply today. Click the link below to submit your application and take the first reputed company toward a rewarding career with reputed company.