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Medical Fraud Investigator Jobs (NOW HIRING)

Fraud Investigator I

Melbourne, FL · Hybrid

$28.13 - $29.79/hr

As a Fraud Investigator I, you will help protect the credit union and its members by investigating ... Medical, dental, and vision insurance, plus an Employee Assistance Program. * Financial Perks ...

Conduct investigations into fraud claims related to online transactions, pre-authorized drafts ... Comprehensive medical, dental and vision insurance plan that has HSA and FSA options * 401(k) plan ...

Investigator - Medicaid Fraud Job Requisition ID: JR0000000386 Number of Openings: 1 Shift: Day ... Assists in developing databases to analyze appropriate medical data. Enters data into databases and ...

$50/hr

Investigator - Medicaid Fraud Job Requisition ID: JR0000000386 Number of Openings: 1 Shift: Day ... Assists in developing databases to analyze appropriate medical data. Enters data into databases and ...

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Medical Fraud Investigator information

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How much do medical fraud investigator jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for medical fraud investigator in the United States is $30.83, according to ZipRecruiter salary data. Most workers in this role earn between $22.12 and $35.34 per hour, depending on experience, location, and employer.

What does a medical fraud investigator do?

A Medical Fraud Investigator is responsible for detecting, investigating, and preventing fraudulent activities related to healthcare claims, billing, and insurance. They analyze medical records, billing data, and other documentation to identify suspicious patterns or inconsistencies. Their work helps protect healthcare programs and insurance companies from financial losses and ensures that resources are used appropriately. Investigators may also collaborate with law enforcement or legal teams if fraudulent activities are confirmed.

How does a medical fraud investigator typically collaborate with healthcare providers and insurance companies during an investigation?

Medical Fraud Investigators regularly work with healthcare providers and insurance companies to gather evidence, clarify billing practices, and verify the legitimacy of claims. This collaboration often involves conducting interviews, reviewing medical records, and coordinating with compliance or legal teams. Building strong professional relationships is essential, as these stakeholders can provide critical information and insights. Effective communication and diplomacy are key, as investigators must balance thoroughness with sensitivity to ongoing provider relationships.

What are the key skills and qualifications needed to thrive as a medical fraud investigator, and why are they important?

To thrive as a Medical Fraud Investigator, you need a solid background in healthcare regulations, investigative techniques, and data analysis, often supported by a degree in criminal justice, healthcare administration, or a related field. Familiarity with claims management systems, data mining tools, and certifications such as Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) is highly beneficial. Strong attention to detail, analytical thinking, and effective communication are crucial soft skills for uncovering fraudulent activities and presenting findings. These skills and qualifications are essential to accurately detect, investigate, and prevent fraud, safeguarding healthcare resources and ensuring compliance.

How do you become a medical fraud investigator?

To become a medical fraud investigator, typically one needs a background in healthcare, criminal justice, or a related field, along with experience in medical billing, coding, or auditing. Many employers prefer candidates with certifications such as the Certified Fraud Examiner (CFE) or healthcare-specific credentials, and strong analytical skills are essential for identifying fraudulent activities.

What qualifications do I need to be a Medical Fraud Investigator?

Medical Fraud Investigators typically need a bachelor's degree in healthcare administration, criminal justice, or a related field. Relevant experience in healthcare, insurance, or law enforcement, along with strong analytical skills and knowledge of medical billing and coding, are also important. Certifications such as Certified Fraud Examiner (CFE) can enhance job prospects.
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Infographic showing various Medical Fraud Investigator job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $64,132 per year, or $30.8 per hour.

Fraud Investigator I

Melbourne, FL • Hybrid

$28.13 - $29.79/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 29 days ago


Job description

At Space Coast Credit Union (SCCU), our members are at the heart of everything we do. Since 1951, we’ve been committed to delivering financial services founded on integrity and a people-first philosophy.

As a Fraud Investigator I, you will help protect the credit union and its members by investigating potential fraud, reviewing fraud cases, and supporting loss prevention efforts. This role partners with law enforcement and internal teams, including Legal, Compliance, and Operations, to identify fraudulent activity, mitigate risk, and strengthen fraud detection and prevention processes.

Why Join SCCU?

  • Member-Focused Mission: Be part of a not-for-profit organization that reinvests in its members.
  • Flexible Schedule Options
  • Career Growth: We prioritize internal promotions and offer on-the-job training.

Fraud Investigator I Key Responsibilities:

  • Reviews high risk activity to determine appropriate action to mitigate potential losses and limit negative member experience.
  • Reports to management any changes in fraudulent activity and potential losses and is knowledgeable about industry trends and regulations.
  • Investigates fraudulent activity, including analyzing data and documents, interviewing witnesses and preparing reports. Performs all necessary follow-up in a timely manner, including contact with law enforcement officials to prevent or reduce loss to members and the organization.
  • Seeks appropriate and timely civil and legal pursuit of members or non-members who have caused a loss to the credit union to recoup losses.
  • Analyze and determine any areas of compromise and vulnerability in order to prevent future reoccurrences and identify and future risks that may not have presented themselves yet. Works in collaboration with other departments to identify areas of vulnerability and assist Leadership in implementing controls to mitigate fraud risk.
  • Works in support of leadership for audit and regulatory requests and training by sharing intelligence and best practices.
  • Stays current with fraud trends in the market by monitoring data from the Fraud Analysts and attending meetings/or conferences in order to prevent fraud losses to the organization and our membership.

Fraud Investigator I Requirements:

  • Associate Degree or specialized certification or equivalent of field experience required.  ABA Certificate in Fraud Prevention, CFCS, and/or CFCP certifications a plus. Adherence to any and all additional regulatory compliance training required throughout the tenure of the position.

  • 3-5 years experience in a financial institution including fraud, claims, and disputes preferred. Prior experience with law enforcement communications or legal proceedings necessary.

Fraud Investigator I Compensation:

  • Starting Salary: $28.13 - $29.79 hourly
  • Bonus Opportunity: Eligible for ONE SCCU Annual Bonus.

Work Schedule

  • Hybrid and Flexible Schedule Options: This position is hybrid with two days per week required in office.
  • Monday – Friday: 8:00 a.m. - 5:00 p.m. Rotating Saturdays

SCCU Benefits

  • Health & Wellness: Medical, dental, and vision insurance, plus an Employee Assistance Program.
  • Financial Perks: 401(k) match (5%), HSA match, and SCCU-paid insurance (short/long-term disability, life insurance).
  • Education Support: Tuition reimbursement after one year of service.
  • Generous Time Off: 20+ days of PTO, birthday PTO, and 11 federal holidays.
  • Exclusive Discounts: Lower rates on loans, credit cards, and no fee SCCU accounts!

About SCCU

Since 1951, Space Coast Credit Union (SCCU) has proudly served our community, growing to over 685,000 members and managing $9 billion in assets. With 67 branches spanning Florida’s east coast, we are the third-largest credit union in the state. In 2025, we expanded into Orange County to better serve the growing East Orlando market.

As a not-for-profit financial institution, SCCU is dedicated to putting our members first. Unlike traditional banks, we return profits to our members through better rates, lower fees, and enhanced services. While we offer the same financial products—like checking, savings, and loans—our focus remains on empowering our members and supporting their financial well-being. With local decision-making and a commitment to exceptional service, we strive to make a meaningful difference in the lives of those we serve.

At SCCU, we also prioritize our team members by fostering a supportive and collaborative environment that encourages career growth and development. As we continue to grow, we are seeking talented, member-focused professionals to join our team and help deliver innovative financial solutions and outstanding service.

I UNDERSTAND this application is a legal document for purposes of employment. Upon acceptance of an offer with SCCU, I understand that I will be required to complete background screening, employment and education verifications, and drug screening. If I am a member of Space Coast Credit Union, my SCCU membership accounts will be reviewed as part of the employment screening process to determine whether they are in good standing, as defined by SCCU policy. Failure to meet these standards may affect employment eligibility, including the possible withdrawal of a conditional offer of employment. I further understand that any misstatements or omissions in this application or during the pre-employment process may be considered falsification and could result in a decision not to hire me, or termination of employment if discovered after hire.

I UNDERSTAND that the information requested regarding date of birth, race, and sex is for the sole purpose of gathering the above information accurately and will not be used to discriminate against me in violation of any law. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and complete the required employment eligibility verification documentation upon hire.

SCCU is a drug-free workplace. I understand that as a condition of employment, I will be required to submit to drug testing and any procedures necessary to assess my qualifications for employment. If hired, I further understand that my employment is for no definite period and may be terminated at any time without prior notice.