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Medical Insurance Fraud Investigator Jobs (NOW HIRING)

APGFCU

Fraud Investigator

Edgewood, MD · On-site

As a Fraud Investigator, you'll play a critical role in protecting APGFCU, our members, and our ... medical and dental (shared expense), vision, 401(k), life and disability insurance, flexible ...

Koalafi

Fraud Investigator

Richmond, VA · On-site

$61K - $74K/yr

As a Fraud Investigator, you will monitor and research risk signals for both customers and ... Comprehensive medical, dental, and vision coverage * 20 PTO days + 11 paid holidays * 401(k) ...

Koalafi

Fraud Investigator

Richmond, VA · On-site

$61K - $74K/yr

As a Fraud Investigator, you will monitor and research risk signals for both customers and ... Comprehensive medical, dental, and vision coverage * 20 PTO days + 11 paid holidays * 401(k) ...

Maine

Fraud Investigator

Portland, ME

$22.91 - $31.97/hr

Health Insurance Coverage - The State of Maine pays 85%-95% of employee-only premiums ($12,213.60 ... Additional, unpaid leave may also be available, under theFamily and Medical Leave Act. * Voluntary ...

Koalafi

Fraud Investigator

Arlington, VA · On-site

$61K - $74K/yr

As a Fraud Investigator, you will monitor and research risk signals for both customers and ... Comprehensive medical, dental, and vision coverage * 20 PTO days + 11 paid holidays * 401(k) ...

TikTok

Fraud Investigator

San Jose, CA · On-site

$121K - $208K/yr

Responsibilities - Conduct investigations of policy violations, data leakage, fraud and financial ... Employees have day one access to medical, dental, and vision insurance, a 401(k) savings plan with ...

State of Maine

Fraud Investigator

Portland, ME · On-site

$22.91 - $31.97/hr

Health Insurance Coverage - The State of Maine pays 85%-95% of employee-only premiums ($12,213.60 ... Additional, unpaid leave may also be available, under the Family and Medical Leave Act. * Voluntary ...

Legacy Management Solutions, LLC

Be Seen First

ACE Fraud Investigator

Detroit, MI · On-site

$28 - $35/hr

Health insurance * Paid time off Education: Bachelor's degree required Experience: Fraud Investigation - 1 year required Ability to Commute: Detroit, MI 48226 required Company Description Our Company ...

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Medical Insurance Fraud Investigator information

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How much do medical insurance fraud investigator jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for medical insurance 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 states have the most Medical Insurance Fraud Investigator jobs?

States with the most job openings for Medical Insurance Fraud Investigator jobs include:

What are popular job titles related to Medical Insurance Fraud Investigator jobs?

For Medical Insurance Fraud Investigator jobs, the most frequently searched job titles are:

Infographic showing various Medical Insurance Fraud Investigator job openings in the United States as of June 2026, with employment types broken down into 9% As Needed, 18% Full Time, 9% Part Time, and 64% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $64,132 per year, or $30.8 per hour.

Fraud Investigator

Deer Park, TX • On-site

SHELL FEDERAL CREDIT UNION
Commercial Banking • 201 - 500 employees
Learn more about SHELL FEDERAL CREDIT UNIONexternal

Full-time

Posted 17 days ago

Job description

Schedule Hours:
M - F: 10:00 AM - 7:00 PM
Saturday's: 9:00 AM - 3:00 PM (Minimum two Saturdays a month)
The Fraud Investigator aides the Operations Department in all areas of fraud mitigation and loss prevention in accordance with Shell FCU's policies and procedures.
Essential Job Duties and Responsibilities
  • Consistently meets all Shell FCU Service Commitments; Shell FCU Employee Creed and Shell FCU Service Distinctions.
  • Maintains a strong knowledge of the financial industry and complies with all applicable rules and regulations required within the scope of duties, including, but not limited to, the Bank Secrecy Act and the Uniform Commercial Code.
  • Attends annual and on-demand training sessions as instructed or scheduled.
  • Performs job duties and responsibilities in compliance with SFCU policies, procedures, philosophy, and standards of performance.
  • Completes all assigned projects in an effective and professional manner.
  • Possesses strong time management skills and consistently meet deadlines.
  • Monitors system queues in the fraud monitoring/anti-money laundering software Verafin to identify high risk transactions within the membership portfolio.
  • Conducts investigations into suspicious activity, including but not limited to scams, check/wire/ACH/card fraud, identity theft, insurance fraud, account takeovers, electronic crimes and elder abuse.
  • Tracks and documents investigations in Verafin case management system.
  • Refers more complex fraud and BSA/AML alerts to the appropriate team members of the Operations Department.
  • Files Suspicious Activity Reports in Verafin as needed.
  • Regularly communicates findings to the Fraud Analyst/Internal Auditor/VP of Operations.
  • Investigates member transactions to identify fraudulent activity such as account takeover, friendly fraud, identity theft or other similar risks.
  • Interacts with credit union employees and members in order to validate information while researching suspected fraud scenarios.
  • Communicates with members by phone or email to validate account activity.
  • Determines existing fraud trends by the analysis of accounts and transaction patterns.
  • Utilizes external resources that identify nationwide and global fraud trends and communicate this information to the Fraud Analyst and/or VP of Operations. Evaluates and recommends improvements of all corporate-wide systems in order to enhance the credit union's fraud prevention program.
  • Recommends mitigation solutions affecting various areas/departments.
  • Works with the Internal Auditors to assist in money laundering investigations to provide a fraud perspective when needed.
  • Assists in the development and implementation of automated fraud detection and real-time decisioning strategies.
  • Acts as a primary resource for internal employees in the areas of fraud and loss prevention.
  • Must be able to work independently with little assistance or supervision.
  • Must be able and willing to work a minimum of 40 hours per week plus overtime as needed.
  • Must be able and willing to work and/or travel to any of our office locations as needed within a 75-mile radius.
  • Must be able to travel to and attend job-related conferences and training, both local and out of state.
  • Performs additional duties as assigned.

Shell Federal Credit Union is an equal opportunity and an affirmative action employer and committed to providing equal opportunity for all employees and applicants for employment, without regard to race, religion, color, sex, sexual orientation, gender identity, national origin, age, citizenship status, marital status, protected veteran status, mental and/or physical disability, pregnancy, or any basis prohibited by State or Federal law.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Knowledge and Skills
Experience:
A minimum of one-year financial institution experience in the areas of lending and operations or one year working in an investigative capacity in an unrelated field.
Education / Training:
High school diploma or general education degree (GED). Some college experience preferred.
Job Requirements:
  • Must possess exceptional investigative skills and a data-driven mindset.
  • Possess exceptional written and verbal communication skills using tact and to reach an objective.
  • Possess a highly positive, member-service oriented attitude and the ability to anticipate member needs.
  • A significant level of trust, diplomacy, and confidentiality is required, in addition to normal courtesy and tact.
  • Work involves extensive personal contact with others and/or can be of a personal or sensitive nature.
  • Work involves motivating or influencing others.
  • Maintain a high level of knowledge and procedural expertise in credit union products, services, and promotions.
  • Perform all work within established policies and procedures.
  • Ability to work in an open-concept workspace/environment.

Physical Demands:
While performing the duties of this job, the employee is regularly required to bend and stand. May at times be able to lift, carry and/or move up to 15 pounds.
Working Conditions
Exposure to potential hazardous conditions-robbery. Employees are to receive detailed instructions and procedures to be followed to minimize risk.
In accordance with the American with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodations will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization.
This Job Description is not a complete statement of all duties and responsibilities comprising this position. Job descriptions are not intended and do not create employment contracts. The organization maintains its status as an at-will employer. Employees can be terminated for any reason not prohibited by law.
This organization uses E-Verify® in its hiring practices to achieve a lawful workforce.

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