Financial Investigator I – Medicaid Fraud Investigator

State of North Carolina

. Conduct complex criminal and civil investigations involving Medicaid provider fraud and patient abuse and neglect .

Posted 10/12/2026full-timeRaleigh • North Carolina • United StatesJuniorMid-Level💰 $57,983 - $69,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting complex investigations related to Medicaid provider fraud and patient abuse, with strong analytical skills in reviewing financial documents and medical records. Proficient in interviewing witnesses and preparing detailed reports while adhering to legal standards and regulations.

Highest-signal resume keywords

Criminal InvestigationsMedicaid Claims AnalysisInterviewing SkillsReport WritingLaw Enforcement Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Financial Document ReviewHealthcare Fraud InvestigationAccounting CourseworkData AnalysisRules of Evidence Application

Soft Skills

Communication SkillsDetail OrientationProblem-Solving Skills

Certifications & Qualifications

Law Enforcement Officer CertificationSpecial Agent Certification

Industry Keywords

MedicaidPatient AbuseHealthcare TerminologyFederal LawsState Regulations

About the role

Key responsibilities & impact

Conduct complex criminal and civil investigations involving Medicaid provider fraud and patient abuse and neglect
Analyze Medicaid claims data
Review financial documents, including bank statements, cancelled checks, and corporate and individual income tax returns
Review medical records and service notes of Medicaid recipients
Interview witnesses, including Medicaid recipients, employees, Medicaid Policy administrators, DHHS employees, and DSS employees
Interview individuals suspected of Medicaid provider fraud and patient abuse and neglect
Prepare detailed reports based on interview results
Work with federal, state, and local law enforcement agencies, including AUSAs
Testify in state and/or federal court
Apply the Rules of Evidence in criminal investigations
Manage investigative assignments and/or projects
Investigate and prosecute healthcare fraud, patient abuse, and embezzlement of patient funds in Medicaid-funded facilities
Protect and recover taxpayer funds and help ensure access to needed medical services for Medicaid enrollees

Requirements

What you’ll need

Bachelor’s degree in accounting, finance, business administration or criminal justice from an appropriately accredited institution
Eighteen credit hours of accounting coursework
Two years of experience in auditing and/or investigating tax, financial, or securities crimes, or equivalent combination of education and experience
May require certification as a Law Enforcement Officer or Special Agent in accordance with the North Carolina Criminal Justice Training and Standards Commission, or ability to achieve certification within one year of employment
Knowledge of applicable state and Federal laws and regulations
Law enforcement experience
Healthcare industry investigator or analyst experience
Familiarity with healthcare terminology and policy
Accounting and/or financial background
Interviewing and report writing experience
Ability to pass a background investigation
Some travel, including occasional overnight stays, required

Benefits

Comp & perks

Employer-paid health insurance
Twelve paid holidays
Vacation leave accrual
Sick leave accrual
Dental insurance
Vision insurance
Other insurance options
Retirement benefits
Reasonable accommodations for employees and applicants with disabilities, pregnancy-related limitations, and religious beliefs, observances, and practices