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Medicare Fraud Jobs (NOW HIRING)

Northwell

Senior Security Investigator

New Hyde Park, NY · On-site

$85K - $147K/yr

Investigations may include, but are not limited to Medicare fraud, financial crimes, internal thefts, identity theft, drug diversions, prescription fraud, or crimes against employees or organization ...

ITC Federal, Inc.

Fraud Analyst

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 ...

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Medicare Fraud information

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How much do medicare fraud jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for medicare fraud in the United States is $26.68, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $32.21 per hour, depending on experience, location, and employer.

What is the difference between Medicare Fraud vs Medical Billing Specialist?

AspectMedicare FraudMedical Billing Specialist
CredentialsKnowledge of healthcare laws, compliance, and sometimes certifications in healthcare complianceCertification in medical billing or coding often preferred
Work EnvironmentHealthcare facilities, government agencies, or legal settingsMedical offices, hospitals, or billing companies
Employer & IndustryGovernment agencies, healthcare providers, legal entitiesHealthcare providers, billing companies, insurance firms
Search & Comparison IntentUnderstanding illegal activities related to MedicareLearning about legitimate billing practices

Medicare Fraud involves illegal activities aimed at unlawfully obtaining Medicare funds, often requiring knowledge of healthcare laws and compliance. In contrast, Medical Billing Specialists focus on accurately processing healthcare claims and ensuring proper billing procedures. While both roles operate within the healthcare industry, Medicare Fraud is associated with illegal activities, whereas Medical Billing Specialists work within legal billing practices.

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

To thrive as a Medicare Fraud Investigator, you need a solid background in criminal justice, healthcare regulations, and investigative techniques, typically supported by a relevant bachelor's degree. Familiarity with data analysis tools, case management software, and knowledge of federal regulations such as HIPAA are crucial. Strong analytical thinking, attention to detail, and effective communication help investigators uncover complex fraud schemes and work with diverse stakeholders. These skills are vital to ensure the integrity of Medicare programs, reduce financial losses, and safeguard public resources.

What are some common challenges faced by professionals working in Medicare fraud investigation roles?

Professionals investigating Medicare fraud often encounter challenges such as navigating complex healthcare regulations, analyzing large volumes of data to identify fraudulent patterns, and staying updated on evolving fraud schemes. Collaboration with other departments and agencies is essential, requiring strong communication and teamwork skills. Additionally, investigators must balance thoroughness with efficiency to ensure cases are resolved in a timely manner, all while maintaining strict confidentiality and legal compliance.

What is Medicare fraud?

Medicare fraud occurs when individuals or organizations intentionally deceive the Medicare program to receive unauthorized benefits or payments. This can include billing for services not provided, falsifying patient diagnoses, or using someone else’s Medicare information to obtain medical care or supplies. Medicare fraud not only wastes taxpayer dollars but also affects the quality and availability of care for those who need it. Detecting and reporting fraud is important for protecting the integrity of the healthcare system.
More about Medicare Fraud jobs
What states have the most Medicare Fraud jobs? States with the most job openings for Medicare Fraud jobs include:
What job categories do people searching Medicare Fraud jobs look for? The top searched job categories for Medicare Fraud jobs are:
Medicare Fraud jobs near you
Infographic showing various Medicare Fraud job openings in the United States as of August 2026, with employment types broken down into 4% As Needed, 79% Full Time, 14% Part Time, and 3% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $55,485 per year, or $26.7 per hour.

Lead Software Developer, Data Analytics

Mitre

Mclean, VA • On-site

Full-time

Re-posted 8 hours ago

MITRE Corporation rating

8.2

Company rating: 8.2 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

157th of 447 rated engineering

Job description

Join the MITRE Data Analytics team where you will provide software development, algorithm development, and data analytics (to include big data analytics, data mining, and data science) to enable data-drive decisions and insights. Experience with analytic techniques and methods (e.g., supervised and unsupervised machine learning, link analysis, and text mining) as well as software languages is a must. Knowledge of data analytics in the heathcare industry. Software languages and big data technologies needed include: Java, Python, R, C#, C, SAS, analytic engines, Hadoop, parallelized analytic algorithms, and NoSQL and massively parallel processing databases. The successful candidate will have the ability to formulate problems, prototype solutions, and to analyze result.
Key Functions: 
• Formulate data analytic problems
• Get and cleanse data
• Employ analytic methods and techniques
• Develop analytic algorithms 
• Analyze data
• Predictive Analytics
• Analyze CMS Health data
• Analyze Medicare Fraud Data
Qualifications:
Hands-on software development skills (Java, R, C++, C#, python, Javascript) with analytic applications and technologies, getting and cleansing data, data storage and retrieval (relational and NoSQL), data analytics and visualization, and cloud-based technologies. Experience with the Map Reduce programming model and technologies such as Hadoop, Hive, and Pig is a plus. Experience analyzing Medicare Fraud data and CMS health data is needed for some projects
Clearance Statement:
Applicants selected for this position will be subject to a government security investigation and must meet eligibility requirements for access to classified information. Only US citizens are eligible for a security clearance. For this position, MITRE will consider only applicants with security clearances or applicants who are eligible for security clearances.
Travel: 
This position will require overnight travel up to 10% of the time as well as some local travel.
Do you meet the above requirements and are interested in learning more about this opportunity? Then apply today or contact us at 571-765-1420 or ashley.tonkinson@MITREcareers.com.
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About MITRE

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Why choose between doing meaningful work and having a fulfilling life? At MITRE, you can have both. That's because MITRE people are committed to tackling our nation's toughest challenges-and we're committed to the long-term well-being of our employees. MITRE is different from most technology companies. We are a not-for-profit corporation chartered to work for the public interest, with no commercial conflicts to influence what we do. The R&D centers we operate for the government create lasting impact in fields as diverse as cybersecurity, healthcare, aviation, defense, and enterprise transformation. We're making a difference every day-working for a safer, healthier, and more secure nation and world. Our workplace reflects our values. We offer competitive benefits, exceptional professional development opportunities, and a culture of innovation that embraces diversity, inclusion, flexibility, collaboration, and career growth. If this sounds like the choice you want to make, then choose MITRE-and make a difference with us. MITRE is a trusted operator of federally funded research and development centers and we're on a mission to make the world a safer place-for all of humanity, today and in the future. To deliver on our mission, we need the world's best talent and leaders-groundbreakers and partnership-builders on a global scale in areas like healthcare, artificial intelligence, critical infrastructure resiliency, pandemic management, and cybersecurity. In return, we have the privilege of backing you with thousands of technical experts in diverse fields, a culture of innovation and knowledge sharing, access to data and resources uniquely available to MITRE through our wide-ranging partnerships across government, industry and academia.

Industry

It services

Company size

5,001 - 10,000 Employees

Headquarters location

McLean, VA, US

Year founded

1958

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