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How much do healthcare fraud jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for healthcare fraud in the United States is $18.82, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $19.47 per hour, depending on experience, location, and employer.

What is healthcare fraud?

Healthcare fraud is the act of intentionally deceiving or misrepresenting information to obtain unauthorized benefits or payments from healthcare programs, such as Medicare or private insurance. This can include billing for services not provided, upcoding procedures, falsifying patient records, or accepting kickbacks. Healthcare fraud can be committed by providers, patients, or even insurance companies, and it not only results in financial losses but can also compromise patient care and trust in the healthcare system.

What is the difference between Healthcare Fraud vs Medical Billing Specialist?

AspectHealthcare FraudMedical Billing Specialist
Required CredentialsNone mandatory, but certifications like Certified Fraud Examiner (CFE) can helpHigh school diploma or equivalent; certifications like Certified Medical Billing Specialist (CMBS) are common
Work EnvironmentHealthcare organizations, government agencies, compliance departmentsMedical offices, hospitals, billing companies
Employer & Industry UsageUsed in compliance, legal, and auditing roles within healthcareUsed in healthcare administration and billing departments
Common Search & ComparisonHealthcare FraudMedical Billing Specialist

Healthcare Fraud involves detecting and preventing illegal billing practices and fraudulent activities within healthcare. In contrast, a Medical Billing Specialist focuses on processing and managing legitimate medical claims and billing procedures. While both roles work within the healthcare industry, Healthcare Fraud professionals focus on compliance and legal issues, whereas Medical Billing Specialists handle day-to-day billing operations.

What are the most common challenges faced by professionals working in healthcare fraud investigation roles?

Professionals in healthcare fraud investigation often encounter challenges such as navigating complex healthcare regulations, staying updated with evolving fraud schemes, and managing large volumes of sensitive data. Collaboration across departments like compliance, legal, and IT is crucial to successfully identify and address fraudulent activities. Investigators may also face tight deadlines and must maintain a high level of accuracy and confidentiality in their work.

What are the key skills and qualifications needed to thrive as a Healthcare Fraud Investigator, and why are they important?

To thrive as a Healthcare Fraud Investigator, you need strong analytical skills, knowledge of healthcare laws and regulations, and experience in auditing or investigations, often supported by a relevant degree or certifications such as Certified Fraud Examiner (CFE). Familiarity with data analysis tools, electronic health record (EHR) systems, and case management software is typically required. Exceptional attention to detail, critical thinking, and effective communication are vital soft skills for gathering evidence and presenting findings clearly. These skills and qualifications are crucial for accurately detecting fraudulent activity, minimizing financial losses, and ensuring compliance within the healthcare industry.
More about Healthcare Fraud jobs
What cities are hiring for Healthcare Fraud jobs? Cities with the most Healthcare Fraud job openings:
What states have the most Healthcare Fraud jobs? States with the most job openings for Healthcare Fraud jobs include:
What job categories do people searching Healthcare Fraud jobs look for? The top searched job categories for Healthcare Fraud jobs are:
Healthcare Fraud jobs near you
Infographic showing various Healthcare Fraud job openings in the United States as of June 2026, with employment types broken down into 18% Locum Tenens, 27% As Needed, 46% Full Time, and 9% Part Time. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $39,156 per year, or $18.8 per hour.

Health Care Fraud Investigator

Legacy Management Solutions

Oxford, MS • On-site

$64K - $87K/yr

Full-time

Posted 20 hours ago

Job description

We are seeking a Health Care Fraud Investigator (HCF Investigator) to support the U.S. Attorney's Office (USAO) in the Northern District of Mississippi. This role involves conducting complex investigations related to civil and administrative healthcare fraud matters, directly supporting Assistant U.S. Attorneys (AUSAs). The investigator will operate independently and collaboratively on sensitive, high-impact cases involving federal programs, organizations, and individuals.Key Responsibilities
  • Plan and conduct healthcare fraud investigations under the direction of AUSAs
  • Analyze applicable federal, state, and local laws to identify violations and legal exposure
  • Gather and evaluate evidence including:
    • Financial records (billing, payroll, invoices)
    • Medical and administrative documentation
    • Digital and forensic data
  • Conduct witness interviews (in-person and telephonic)
  • Coordinate with federal agencies such as:
    • FBI
    • HHS
    • DOL
    • USPIS
    • SEC
  • Develop investigative strategies and determine methods for evidence collection
  • Prepare interim and final investigative reports for litigation use
  • Assist AUSAs with:
    • Trial preparation
    • Evidence organization
    • Witness coordination
  • Testify in court as required
  • Support surveillance coordination (non-enforcement; no arrest authority)
Qualifications
  • Bachelor's degree or higher
  • Minimum 5+ years of investigative experience in a related field
  • Experience with healthcare fraud, civil investigations, or regulatory enforcement preferred
  • Strong ability to analyze complex financial and documentary evidence
  • U.S. Citizenship required
Security Requirements
  • Must be eligible for a High-Risk Background Investigation (BI)
  • Includes:
    • Background check
    • Credit check
    • Drug screening
Work Environment
  • On-site at:
    U.S. Attorney's Office
    900 Jefferson Avenue
    Oxford, MS
  • Standard hours: Monday-Friday, 8:00 AM - 5:00 PM
  • Limited travel within the district (reimbursable per federal guidelines)

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