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Medicaid Investigator Jobs (NOW HIRING)

State of Georgia

$50/hr

Investigator - Medicaid Fraud Job Requisition ID: JR0000000386 Number of Openings: 1 Shift: Day (United States of America) Compensation Details: STARTING IN THE $50'S (COMMENSURATE WITH EXPERIENCE ...

Georgia

Investigator - Medicaid Fraud

Atlanta, GA · On-site

$50/hr

Investigator - Medicaid Fraud Job Requisition ID: JR0000000386 Number of Openings: 1 Shift: Day (United States of America) Compensation Details: STARTING IN THE $50'S (COMMENSURATE WITH EXPERIENCE ...

State of Georgia

$70/hr

Job Title: Criminal Investigator - Medicaid Fraud Division Job Requisition ID: JR0000001107 Number of Openings: 2 Shift: Day (United States of America) Compensation Details: MINIMUM $70 ...

Northwell

Financial Services Representative

Melville, NY · On-site

$34K - $51K/yr

Performs financial assessment of patients; refers potential Medicaid cases to Medicaid Investigator. * Gathers documentation and assists in the completion of the Financial Assistance Program (FAU ...

Northwell

Financial Services Representative

Bay Shore, NY · On-site

$34K - $51K/yr

Performs financial assessment of patients; refers potential Medicaid cases to Medicaid Investigator. * Gathers documentation and assists in the completion of the Financial Assistance Program (FAU ...

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Medicaid Investigator information

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$32K

$75.3K

$131K

How much do medicaid investigator jobs pay per year?

As of Sep 8, 2026, the average yearly pay for medicaid investigator in the United States is $75,325.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,500.00 and $98,500.00 per year, depending on experience, location, and employer.

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

A Medicaid Investigator typically needs a background in criminal justice, auditing, or healthcare administration, along with knowledge of Medicaid regulations and investigative procedures. Proficiency with case management systems, data analysis tools, and relevant certifications such as Certified Fraud Examiner (CFE) are highly valuable. Strong analytical thinking, attention to detail, and effective communication skills help investigators identify fraud and collaborate with legal teams. These skills are crucial for ensuring program integrity, preventing financial losses, and maintaining public trust in Medicaid services.

What are some common challenges Medicaid Investigators face when working on fraud cases?

Medicaid Investigators often encounter challenges such as navigating complex regulations, gathering sufficient evidence, and coordinating with multiple agencies. Fraud cases can be intricate, requiring attention to detail and persistence when analyzing large volumes of data and interviews. Investigators must also balance the need for thoroughness with deadlines, all while maintaining confidentiality and professionalism. Strong communication and problem-solving skills are vital to overcome these hurdles and ensure the integrity of Medicaid programs.

What is the difference between Medicaid Investigator vs Medicaid Fraud Analyst?

AspectMedicaid InvestigatorMedicaid Fraud Analyst
Required CredentialsHigh school diploma or equivalent; some roles may require relevant certificationsSimilar; often requires certifications in fraud detection or compliance
Work EnvironmentField investigations, interviews, and on-site inspectionsOffice-based analysis, data review, and report writing
Employer & Industry UsageState Medicaid agencies, law enforcement, and healthcare organizationsState Medicaid agencies, healthcare compliance firms, and government agencies

Both roles involve working within Medicaid programs, but Medicaid Investigators focus on field investigations and enforcement, while Medicaid Fraud Analysts primarily analyze data and identify potential fraud remotely. The roles often overlap in credentials and industry usage, but differ in daily tasks and work environment.

How to become a Medicaid investigator?

To become a Medicaid investigator, candidates typically need a bachelor's degree in criminal justice, social work, or a related field, along with experience in investigations or healthcare. State-specific training and certification may be required, and knowledge of Medicaid policies and investigative techniques are important for success in this role.
More about Medicaid Investigator jobs

What cities are hiring for Medicaid Investigator jobs?

Cities with the most Medicaid Investigator job openings:

What states have the most Medicaid Investigator jobs?

States with the most job openings for Medicaid Investigator jobs include:

What are popular job titles related to Medicaid Investigator jobs?

For Medicaid Investigator jobs, the most frequently searched job titles are:

Medicaid Investigator jobs near you
Infographic showing various Medicaid Investigator job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 81% Full Time, 12% Part Time, and 4% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $75,325 per year, or $36.2 per hour.

Medicaid Investigator

New Hyde Park, NY • On-site

Northwell Health
Hospitals • 10K+ employees
Learn more about Northwell Healthexternal

Part-time

This job post has expired 1 day ago. Applications are no longer accepted.

Key responsibilities

  • Assists patients and families in completing Medicaid applications and assesses their eligibility.

  • Contacts and coordinates with various agencies, physicians, and hospital staff to obtain necessary information and resolve cases.

  • Maintains records, enters data into relevant systems, and schedules clinical visits related to Medicaid screening.

Northwell Health rating

7.7

Company rating: 7.7 out of 10

Based on 569 frontline employees who took The Breakroom Quiz

164th of 898 rated healthcare providers

Job description

Assists patient/family in completing Medicaid application. Assesses patient's eligibility for Medicaid. Verifies patient's information to complete application. Coordinates with various agencies and individuals to resolve individual cases.

Job Responsibility

  • Provides information regarding Medical Center regulations and policies pertaining to medical coverage
  • Contacts patient/family and conducts interviews for the purpose of assessing Medicaid eligibility.
  • Meets with and assists patient/family in completing Medicaid applications in order to ensure coverage for Hospital, Nursing Facility, Home Care services and community Medicaid.
  • Checks patient account for pervious balances and advises patient of all financial obligations.
  • Informs patient of Medical Center's collection policy.
  • Contacts physicians, nurses, social workers, employers, banks, etc to obtain appropriate medical, legal and financial information to complete Medicaid application. Notifies appropriate hospital staff regarding Medicaid eligibility status and determination.
  • Coordinates with various city and county agencies to resolve individual cases.
  • Answers the telephone and maintains files. Informs Supervisor of activities, issues and problem cases. Accumulates data for performance reports.
  • Maintains departmental files and statistical logs. Enters data into Medical Center's patient registration system, financial management system, as well as, Medical Eligibility Program database.
  • Assists in scheduling patients for clinical visits, pre-admission testing, special tests and consultations via Medicaid screening process.
  • Performs related duties as required.

*ADA Essential Functions

Job Qualification

  • High School Diploma or equivalent, required.
  • Minimum of two (2) years experience in financial planning and assessment, with regard to Medicaid and third party reimbursement sources.
  • Ability to evaluate, research and document financial histories of patients in relation to Medicaid regulations.
  • Good writing, organizational, interviewing and advocacy skills are essential.
  • Demonstrated ability to operate data entry equipment, required.
  • Ability to work well under pressure. Heavy customer service/telephone contact.


*Additional Salary Detail 
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

Northwell Health

At Northwell Health, we're a network of collaborators, research pioneers, entrepreneurs and educators-74,000+ strong-each year caring for millions of individuals and their families who share our neighborhoods and communities where we live, love and work.  

Northwell is a Fortune 100 Best Companies to Work for, the only health care provider in New York State to be recognized. As New York State's largest healthcare provider and employer, Northwell has many career opportunities across our 23 hospitals, nearly 800 outpatient facilities, our laboratories, and our world-class research facility with locations spanning across Long Island, Manhattan, Queens, Staten Island and Westchester. Our team members have limitless opportunities for career growth, learning and development with a rewarding and inclusive culture that supports and nurtures their professional journey at every step of the way. A Northwell career is a career well cared for.


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