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Medicaid Fraud Analyst Jobs (NOW HIRING)

Investigator - Medicaid Fraud Job Requisition ID: JR0000000386 Number of Openings: 1 Shift: Day ... Assists criminal justice personnel, including, but not limited to, Analysts, Auditors, and ...

Fraud Analyst Location US- ID 2026-1567 Remote Yes Overview JOB TITLE: Fraud Analyst AGENCY ... Familiarity with specific subject matter helpful - Medicare and Medicaid claims, student loan ...

Fraud Analyst AGENCY SUPPORTED: U.S. Department of Justice (DOJ) - MEGA 6 Automated Litigation ... Familiarity with specific subject matter helpful - Medicare and Medicaid claims, student loan ...

Medicaid Fraud Investigator

Chicago, IL · Remote

$31.25 - $35/hr

Medicaid Fraud Investigator - Special Investigations Unit (SIU) Location: [Remote - ideally in the ... As an SIU Investigator, you won't just analyze data--you'll actively protect healthcare integrity ...

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Medicaid Fraud Analyst information

See salary details

$31K

$56.8K

$130.5K

How much do medicaid fraud analyst jobs pay per year?

As of Aug 5, 2026, the average yearly pay for medicaid fraud analyst in the United States is $56,776.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,000.00 and $55,000.00 per year, depending on experience, location, and employer.

What is a Medicaid fraud analyst?

Medicaid Fraud Analysts are professionals responsible for investigating, detecting, and preventing fraudulent activities within the Medicaid program. They analyze data, conduct research, and collaborate with law enforcement and other agencies to identify improper billing, false claims, or abuse of Medicaid funds. Their work helps ensure that Medicaid resources are used appropriately and that fraudsters are held accountable. Medicaid Fraud Analysts play a vital role in protecting taxpayer dollars and maintaining the integrity of the healthcare system.

What is the difference between Medicaid Fraud Analyst vs Medicaid Compliance Specialist?

AspectMedicaid Fraud AnalystMedicaid Compliance Specialist
Required CredentialsTypically a bachelor’s degree in criminal justice, healthcare administration, or related field; certifications like CFE (Certified Fraud Examiner) are commonSimilar credentials; often holds certifications like CHC (Certified in Healthcare Compliance) or CCEP (Certified Compliance & Ethics Professional)
Work EnvironmentGovernment agencies, healthcare organizations, or insurance companies focusing on fraud detectionHealthcare providers, insurance companies, or regulatory agencies ensuring compliance with Medicaid policies
Employer & Industry UsageUsed in government and private sectors to identify and investigate Medicaid fraudUsed across healthcare organizations to ensure adherence to Medicaid regulations and policies

Both roles require knowledge of Medicaid policies and investigative skills. While Medicaid Fraud Analysts focus on detecting and investigating fraud, Medicaid Compliance Specialists ensure organizations follow Medicaid rules. Both positions are vital in maintaining program integrity and often collaborate within healthcare compliance teams.

What are some common challenges faced by Medicaid fraud analysts when investigating potential fraud cases?

Medicaid Fraud Analysts often encounter challenges such as sifting through large volumes of complex data to identify suspicious patterns, staying updated on evolving fraud tactics, and ensuring compliance with legal and regulatory standards. Collaborating with healthcare providers, law enforcement, and legal teams requires clear communication and attention to detail. Additionally, analysts must balance thorough investigations with the need for timely resolution to prevent ongoing fraudulent activity and minimize financial losses for the Medicaid program.

What are the key skills and qualifications needed to thrive as a Medicaid fraud analyst?

To thrive as a Medicaid Fraud Analyst, you need strong analytical skills, attention to detail, and knowledge of healthcare regulations, typically supported by a bachelor’s degree in criminal justice, healthcare administration, or a related field. Familiarity with data analysis tools, case management systems, and fraud detection software is essential. Excellent communication, critical thinking, and investigative skills help you collaborate with law enforcement and present findings effectively. These abilities are vital for accurately identifying, investigating, and preventing fraudulent activities that can harm public health programs.
More about Medicaid Fraud Analyst jobs
What cities are hiring for Medicaid Fraud Analyst jobs? Cities with the most Medicaid Fraud Analyst job openings:
What states have the most Medicaid Fraud Analyst jobs? States with the most job openings for Medicaid Fraud Analyst jobs include:
Infographic showing various Medicaid Fraud Analyst job openings in the United States as of July 2026, with employment types broken down into 89% Full Time, 6% Part Time, 1% Temporary, and 4% Contract. Highlights an 83% Physical, 7% Hybrid, and 10% Remote job distribution, with an average salary of $56,776 per year, or $27.3 per hour.

$39K - $51K/yr

Full-time

Posted 15 days ago


Job description

Position Information Section: Medicaid Fraud Control Section/Criminal Law Division Class: Medicaid Fraud Analyst I/II Location: Harrisburg Telework: This position will report to the headquartered location a minimum of 2 days per week. You may have the opportunity to telework the remainder of the week, if desired and based on business need. Position Type: Full-time, Non-civil service, Union Work Hours: 8:30 - 5:00 Salary Range: Medicaid Fraud Analyst I - Pay Range 5: Starting salary $46,827 Medicaid Fraud Analyst II - Pay Range 7: Starting salary $60,538 Basic Function An employee in this position performs work which involves the retrieval, analysis, and compilation of data and the verification and dissemination of information pertinent to investigations into the Medicaid Fraud and Abuse amendments, the Neglect of Care-Dependent Persons Act, and other applicable State and Federal regulations.

The employee is responsible for assisting with/conducting the retrieval, compilation, and summarization of information needed by Special Agents in the course of an investigation. Supervision is received from an investigative or administrative superior who reviews the work while in progress and upon completion. Examples Of Duties Assists with determining, or determines under the direction and guidance of an experienced analyst and/or supervisor, data requirements, sources, and parameters and gathers the needed information within the given time constraints using a variety of methods, inclusive of various computer programs Meets with appropriate personnel within the OAG or other governmental agencies to ascertain needs with respect to assignments Makes requests for pertinent documents needed for the analysis of referrals/intake complaints or pending information Contacts individuals to schedule meetings, and participates in the meetings, in order to gather needed data Assists with the preparation of, or prepares under the direction and guidance of an experienced analyst and/or supervisor, summarizations of data gathered by editing, compiling, and tabulating Provides assistance to agents relative to data checks, background checks, and claims histories Assists with the execution of search warrants for the purpose of cataloging data and documentary evidence Assists with the conduct of, or conducts under the direction and guidance of an experienced analyst and/or supervisor, various surveys of limited scope when an assignment requires such and prepares reports of findings Prepares spreadsheets, charts, and graphs Assists with the review of, or reviews under the direction and guidance of an experienced analyst and/or supervisor, computer printouts, vouchers, or other documents to ascertain the needed data Provides litigation support through the preparation and presentation of material/evidence for official proceedings/court Testifies in court proceedings and grand jury proceedings regarding analytical findings.

Inputs data into computer system by utilizing a computer keyboard Performs other duties as assigned Minimum Experience and Training Qualifications for Medicaid Fraud Analyst I are as follows: A Bachelor's Degree from an accredited institution OR Graduation from high school and four years of relevant experience that would afford the individual the needed knowledge and skills to perform the job OR Any equivalent combination of education, training, and experience that would enable the individual to perform the duties of the job Qualifications for Medicaid Fraud Analyst II are as follows: A Bachelor's Degree from an accredited institution and two years of relevant experience that would afford the individual the needed knowledge and skills to perform the job OR A Master's Degree in criminal justice or a related field OR Graduation from high school and six years of relevant experience that would afford the individual the needed knowledge and skills to perform the job OR Any equivalent combination of education, training and experience that would enable the individual to perform the duties of the job Preferred Knowledge, Skills, and Abilities Knowledge of Microsoft Excel (advanced) Experience using Pivot Tables Possess excellent oral and written communication skills and be able to communicate with employees throughout all levels of the organization Ability to work both independently and in a team environment