Auditor/Investigator II

🕒 September 10

⛰️ Colorado, Louisiana, +4 more states – Remote

⛰️ Colorado – Remote ⚜️ Louisiana – Remote 🌶️ New Mexico – Remote 🌪️ Oklahoma – Remote 🎸 Mississippi – Remote 🤠 Texas – Remote

💵 $57.5k - $85.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

👻 Ghost score 13%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Qlarant

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1973

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Qlarant is a US-based services and technology firm specializing in healthcare program integrity, offering quality improvement, fraud, waste & abuse (FWA) detection and investigative services, and advanced data analytics and predictive modeling tools (the RIViR® Risk Solution Suite) for government agencies, health plans, and related sectors. The company also operates initiatives like the Qlarant Foundation and Qlarant Capital to fund grants and early-stage startups, and provides pharmacy, drug pricing, and transportation-focused solutions.

📋 Description

• Ensure the integrity and accuracy of claims processes and protocols • Collect and analyze data for audits and investigations into customer claims • Review documentation and interview witnesses, claimants, and stakeholders • Identify fraud, waste, abuse, and discrepancies in claims submissions • Assess claims validity and provide recommendations to management for resolution and closure • Document findings and prepare comprehensive reports for legal or audit/investigative purposes • Conduct impartial audits and investigations from start to closure • Address customer inquiries and concerns, escalating matters as needed • Compile organized records in compliance with legal and regulatory requirements • Create and implement strategies to identify and prevent fraudulent activities • Communicate with internal teams and external stakeholders regarding audit and investigation findings • Assist with training and supporting other auditors/investigators

🎯 Requirements

• Minimum Bachelor's Degree required; education can be substituted for experience • 2–4 years of experience required; 5–7 years preferred • Healthcare fraud experience desired • Knowledge of Medicare preferred • Certified Fraud Examiner certification preferred • Successful completion of pre-employment background and drug screens required • Ability to conduct audits and investigations, analyze claims data, review documentation, interview involved parties, and communicate findings • Ability to comply with legal, regulatory, and industry requirements

🏖️ Benefits

• Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities • Drug-free workplace • Employment offers contingent upon successful completion of pre-employment background and drug screens