Auditor/Investigator II

🔥 1 hour ago

🌵 Arizona, California, +8 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🥔 Idaho – Remote 🦬 Montana – Remote 🎰 Nevada – Remote 🌾 North Dakota – Remote 🌲 Oregon – Remote 🗿 South Dakota – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $57.5k - $85.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

👻 Ghost score 0%

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 data for audits and investigations into claims • Review documentation and interview involved parties • Identify fraud, waste, abuse, and discrepancies in claims submissions • Analyze data to assess claims validity • Recommend claim resolution and closure to management • Document and input findings • Conduct impartial audits and investigations from start to closure • Address customer inquiries and concerns and escalate matters as needed • Compile organized audit and investigation records • Create and implement strategies to identify and prevent fraudulent activities • Communicate with internal teams to process audits and investigations properly • Communicate findings and updates to customers, claimants, and stakeholders • Assist with training and supporting other auditors/investigators • Plan and arrange own work while working with a manager to prioritize projects

🎯 Requirements

• Minimum Bachelor's Degree required; education can be substituted for experience • 2–4 years of experience required; 5–7 years preferred • Certified Fraud Examiner preferred • Ability to conduct claims audits and investigations from start to closure • Analytical skills and attention to detail • Ability to review documentation and analyze claims data • Ability to interview witnesses, claimants, and stakeholders • Knowledge of legal, regulatory, and industry requirements • Ability to prepare comprehensive reports for legal or audit/investigative purposes • Ability to communicate with customers, claimants, internal teams, and other stakeholders

🏖️ Benefits

• Employment offers contingent upon successful completion of pre-employment background and drug screens • Equal Opportunity Employer • Drug-free workplace