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Medicaid Fraud Control Unit Jobs in Tennessee (NOW HIRING)

What We Are Looking For We are seeking a motivated and detail-oriented Fraud Risk Unit (FRU ... Anticipate control gaps and designed strategic interim and automated solutions to safeguard ...

... control gaps and emerging fraud typologies. • Handle partner escalations and support regulatory ... Unit (CIU) to improve fraud onboarding metrics. • Coordinate with law enforcement agencies on ...

What We Are Looking For We are seeking a motivated and detail-oriented Fraud Risk Unit (FRU ... Anticipate control gaps and designed strategic interim and automated solutions to safeguard ...

... unit. The Auditor will perform audit activities related to the detection and investigation of fraud ... Centers for Medicare & Medicaid claims data, PPP loan data, and activities of entities and ...

Auditor

Knoxville, TN

$80K - $100K/yr

... unit. The Auditor will perform audit activities related to the detection and investigation of fraud ... Review, analyze, and interpret complex data, including Centers for Medicare & Medicaid claims data ...

... unit. The Auditor will perform audit activities related to the detection and investigation of fraud ... Review, analyze, and interpret complex data, including Centers for Medicare & Medicaid claims data ...

Review and authorize large or complex medical bills, negotiating adjustments to control costs ... Lead investigations into complex fraud cases and collaborate with the Special Investigations Unit.

Social Work Services in establishing Medicaid pending cases for placement in long-term care ... unit's services and patient flow. 13. May assist other department personnel, as the work schedule ...

Store Manager 1078

Knoxville, TN · On-site

$15 - $19.50/hr

... control procedures and informing management and/or appropriate officials of potential fraud risk ... Is responsible for the overall direction, coordination, and evaluation of this unit. * Carries out ...

... control procedures and informing management and/or appropriate officials of potential fraud risk ... Is responsible for the overall direction, coordination, and evaluation of this unit. * Carries out ...

... control procedures and informing management and/or appropriate officials of potential fraud risk ... Is responsible for the overall direction, coordination, and evaluation of this unit. * Carries out ...

Store Manager 1078

Knoxville, TN · On-site

$15 - $19.50/hr

... control procedures and informing management and/or appropriate officials of potential fraud risk ... Is responsible for the overall direction, coordination, and evaluation of this unit. * Carries out ...

... control procedures and informing management and/or appropriate officials of potential fraud risk ... Is responsible for the overall direction, coordination, and evaluation of this unit. * Carries out ...

Medicaid Fraud Control Unit information

See Tennessee salary details

$35.4K

$65.7K

$92.6K

How much do medicaid fraud control unit jobs pay per year?

As of Aug 16, 2026, the average yearly pay for medicaid fraud control unit in Tennessee is $65,712.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,600.00 and $63,100.00 per year, depending on experience, location, and employer.

What is a Medicaid Fraud Control Unit?

A Medicaid Fraud Control Unit (MFCU) job involves investigating and prosecuting fraud related to Medicaid funds, as well as cases of patient abuse or neglect in healthcare facilities. Professionals in this role work to identify fraudulent billing practices, recover improperly used funds, and ensure compliance with state and federal laws. MFCU teams typically include investigators, attorneys, and auditors who collaborate to build cases against individuals or organizations committing Medicaid fraud. These roles are critical in protecting public resources and ensuring vulnerable populations receive proper care.

What are the typical daily responsibilities for someone working in a Medicaid Fraud Control Unit?

Professionals in a Medicaid Fraud Control Unit spend their days conducting investigations into suspected fraud, waste, or abuse involving Medicaid providers or recipients. Daily tasks often include reviewing medical records, analyzing financial data, interviewing witnesses, preparing reports, and collaborating with law enforcement agencies or prosecutors. Team members also attend multidisciplinary meetings and may participate in court proceedings as expert witnesses. This role requires balancing independent research with close teamwork to build strong, evidence-based cases that protect the integrity of Medicaid programs.

What are the key skills and qualifications needed to thrive in the Medicaid Fraud Control Unit position, and why are they important?

To excel in a Medicaid Fraud Control Unit, you need expertise in investigative techniques, healthcare regulations, and fraud detection, usually backed by a background in criminal justice, law, or healthcare administration. Familiarity with data analysis software, case management systems, and legal research tools is often required. Strong analytical thinking, attention to detail, and effective communication skills set individuals apart in this field. These abilities are crucial for identifying, investigating, and prosecuting fraud, ensuring compliance, and protecting public resources.

Infographic showing various Medicaid Fraud Control Unit job openings in Tennessee as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $65,712 per year, or $31.6 per hour.

Fraud Risk Unit Analyst

THREAD BANK

Nashville, TN • On-site

Full-time

Posted 12 days ago


Job description

Description:

Who We Are

Thread Bank is a digital-first financial technology community bank that aims to enhance customer engagement through innovative solutions. Thread Bank offers a modern website, a CRM system, and a mobile app to simplify banking for businesses and individuals. Our embedded banking solution helps business technology platforms provide secure banking experiences. We also partner with other banks, credit unions, and FinTechs to integrate compliant financial solutions. Thread Bank values innovation, collaboration, and flexibility, offering excellent benefits and a family-friendly culture.


What We Are Looking For

We are seeking a motivated and detail-oriented Fraud Risk Unit (FRU) Analyst to support the monitoring, investigation, and resolution of fraud cases at Thread. This role is a critical part of the bank’s fraud program, working within the Financial Crimes Compliance (FCC) team to help detect, investigate, and mitigate fraud across our products and Partner channels.


The ideal candidate has at least 3 years of fraud or financial crimes experience, strong analytical skills, and curiosity about emerging fraud patterns. They should be comfortable managing fraud investigations end-to-end while supporting the buildout of fraud metrics, automation, and program standards. A demonstrated interest in pursuing professional certifications (such as the CFE) is strongly preferred. Position is Nashville, TN office based, M-F 8-5PM CT.


What You’ll Do

• Review fraud alerts and conduct investigations into suspicious customer activity.

• Manage complex fraud investigations, including account takeovers, synthetic identities, and internal fraud.

• Conduct root cause analysis and pattern detection to identify control gaps and emerging fraud typologies.

• Handle partner escalations and support regulatory reporting requirements.

• Investigate internal fraud and account abuse cases, coordinating with HR and Legal as appropriate.

• Prepare and contribute to enterprise fraud reporting, metrics, and dashboards.

• Partner with the Customer Intelligence Unit (CIU) to improve fraud onboarding metrics.

• Coordinate with law enforcement agencies on escalated cases when necessary.

• Anticipate control gaps and designed strategic interim and automated solutions to safeguard compliance.

• Lead development of investigative standards and fraud case playbooks.

• Collaborate with the Quality Control (QC) team to build and refine fraud metrics and testing processes.

• Partner with Technology and Operations to support automation of initial detection workflows (e.g., Fraud Inbox).

• Document case details, findings, and decisions clearly in the case management system.

• Support customer outreach during investigations, including gathering documentation or clarifications.

• Contribute to the maintenance of fraud typology libraries, red flags, and detection strategies.

• Participate in fraud-related projects such as testing, data validation, or process improvement initiatives.


Qualifications

• 3+ years of fraud, financial crimes, compliance, or related experience (banking or fintech preferred).

• Solid understanding of fraud risks and common fraud schemes (e.g., account takeover, synthetic identity, payment fraud).

• Familiarity with transaction monitoring, fraud detection tools, or case management platforms.

• Strong analytical, investigative, and problem-solving skills with attention to detail.

• Excellent written and verbal communication skills, including SAR narrative writing and case documentation.

• Proven ability to manage multiple priorities and meet deadlines in a fast-moving environment.

• Demonstrated interest in pursuing professional certifications (e.g., Certified Fraud Examiner (CFE)).

• Strong collaboration skills with the ability to work across Compliance, Operations, Technology, and external partners.


Employee must be able to perform essential functions of the position and, if requested, Thread Bank will make reasonable accommodations to enable employees with disabilities to perform the essential functions of their job, absent undue hardship, in accordance with the ADA.


Thread Bank is an Equal Opportunity Employer. Thread Bank does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.


By submitting your application, you give Thread Bank permission to email, call, or text you using the contact details provided. We will only contact you with job-related information.


Requirements: