Senior Fraud Investigator: Complex Cases

Medica; Minnetonka (MN); Hybrid; USD 63,000 - 94,000; Full time

Job summary

Medica is seeking an SIU Investigator III in Minnetonka, MN to conduct complex fraud investigations, onsite audits, and collaborate with legal/regulatory partners. The role emphasizes data-driven analysis, thorough documentation, and professional representation in external investigations.

Office-based role requiring onsite presence in Minnetonka, MN about three days per week with a comprehensive compensation package and benefits.

Qualifications

• Bachelor's degree in criminal justice, criminology, healthcare administration or related field.
• 5+ years of work experience in fact-finding, criminal or fraud detection, investigation and research.

Responsibilities

• Conduct Complex Fraud, Waste, & Abuse Investigations and document evidence.
• Perform Onsite Audits & Provider Reviews and assess compliance.
• Collaborate with Legal, Regulatory, & Law Enforcement partners on case strategy.
• Support SIU processes, documentation, & compliance requirements.
• Provide expertise and guidance on investigative methods and fraud indicators.
• Performs other duties as assigned.

Skills

Criminal justice

Fraud detection

Investigation

Education

Bachelor's degree (Criminal justice/related)

Tools

Snowflake

Job description

Medica is seeking an SIU Investigator III in Minnetonka, MN to conduct complex fraud investigations, onsite audits, and collaborate with legal/regulatory partners. The role emphasizes data-driven analysis, thorough documentation, and professional representation in external investigations.

Office-based role requiring onsite presence in Minnetonka, MN about three days per week with a comprehensive compensation package and benefits.