LogoFresh Jobs Ahead
State of North Carolina
State of North Carolina
EducationHealthcareLogistics
State of North Carolina is the state government serving residents, businesses, and visitors through public agencies, programs, and the nc.gov portal. Its work spans healthcare, education, transportation and logistics, taxes, employment, voting, public safety, and social services. The organization also publishes official news, alerts, agency directories, and practical guidance, making it a broad public-sector employer for people interested in government services and statewide programs.
LinkedIn
Company Jobs

Financial Investigator I, Medicaid Fraud

Investigate Medicaid provider fraud, patient abuse, and embezzlement for the North Carolina Department of Justice. Analyze claims and financial records, interview witnesses, and support court proceedings.

USUnited StatesNCNorth Carolina
$57,983 – $69,000 / year
On-siteFull-timeJuniorMiddleEnglish RequiredFinancial Planning and Analysis

Description

  • Investigate complex criminal and civil cases involving Medicaid provider fraud, patient abuse, and neglect
  • Analyze Medicaid claims data
  • Examine financial records such as bank statements, cancelled checks, and corporate and personal tax returns
  • Review Medicaid recipients’ medical records and service notes
  • Interview witnesses, including recipients, employees, Medicaid Policy administrators, and DHHS and DSS staff
  • Interview people suspected of Medicaid provider fraud, patient abuse, or neglect
  • Write detailed reports based on interview findings
  • Coordinate with federal, state, and local law enforcement agencies, including Assistant U.S. Attorneys
  • Give testimony in state or federal court
  • Apply rules of evidence during criminal investigations
  • Manage investigative assignments and projects
  • Investigate and prosecute healthcare fraud, patient abuse, and embezzlement of patient funds at Medicaid-funded facilities
  • Protect and recover taxpayer funds while helping maintain Medicaid enrollees’ access to necessary medical services

Requirements

  • Bachelor’s degree in accounting, finance, business administration, or criminal justice from an appropriately accredited institution
  • At least 18 credit hours of accounting coursework
  • Two years of experience auditing or investigating tax, financial, or securities crimes, or an equivalent combination of education and experience
  • Certification as a Law Enforcement Officer or Special Agent under the North Carolina Criminal Justice Training and Standards Commission may be required; candidates may be able to obtain it within one year of hire
  • Knowledge of applicable state and federal laws and regulations
  • Law enforcement experience
  • Experience investigating or analyzing within the healthcare industry
  • Familiarity with healthcare terminology and policy
  • Accounting or financial experience
  • Experience interviewing and writing reports
  • Ability to pass a background investigation
  • Availability for some travel, including occasional overnight stays

Benefits

  • Health insurance paid by the employer
  • 12 paid holidays
  • Accrued vacation leave
  • Accrued sick leave
  • Dental insurance
  • Vision insurance
  • Additional insurance options
  • Retirement benefits
  • Reasonable accommodations for employees and applicants related to disabilities, pregnancy-related limitations, and religious beliefs, observances, and practices

Related Jobs