How to Become a Medicare Fraud Investigator
Medicare fraud occurs when a person intentionally misrepresents themselves with the intent to wrongfully bill Medicare for services. Medicare fraud investigators work for various health care institutions investigating allegations of Medicare fraud and abuse. Investigators must possess a strong understanding of various forms of Medicare benefit fraud.
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Instructions
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Obtain at least a high school diploma, though companies generally prefer applicants with a college degree. A college education and two years of professional experience qualifies you to sit for the Certified Fraud Examiner (CFE) exam, which is a highly regarded credential in the fraud investigation industry.
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Apply for associate membership with the Association of Certified Fraud Examiners (ACFE). The cost of associate membership is $95 per year as of 2009.
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Apply for the CFE exam and pay the exam fee. You will need to submit verifiable proof that you have at least two years of direct or indirect fraud-related experience. The CFE exam is made up of four sections: Criminology & Ethics, Financial Transactions, Fraud Investigation and Legal Elements of Fraud. You must pass all four sections in order to be eligible for certification.
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Pass the CFE exam and receive notification from the ACFE within 2-3 business days about your certification as a new CFE.
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Search for Medicare fraud investigator positions with healthcare providers and insurance companies. Be sure to indicate on your resume that you have a prior fraud investigation experience and are a CFE.
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