A fraud investigator is someone who does research into a particular case to ensure that a victim is truthful with his or her comments. Often used in the health care industry, these men and women help keep costs down and keep fraudulent cases out of the courtroom. When someone files a personal injury or a medical malpractice case, the investigator will look at all factors surrounding that case to determine if the case has merit. This is one of the few career paths in the medical field that do not require a college degree.
Education Needed for the Job
You can find a job as an investigator with only a high school diploma or the equivalent of a high school diploma. Many of the companies that hire investigators care more than applicants have experience and training and that they can handle the duties associated with the job, including a basic understanding of medical terminology and the ability to work independently without a direct supervisor. Some employers look for those who have some college experience, and other employers prefer hiring investigators with a degree in criminal justice or a medical topic.
Experience Needed for the Job
The amount of experience required of a fraud investigator varies based on the job type and employer. Most employers look for applicants with at least one year of experience in an investigation field or a fraud field, and other employers want people with a minimum of three to five years of experience. If you’re currently enrolled in college, check with your school about internships and fieldwork experience available in your area. Some schools have partnerships in place with insurance companies that will let you gain some experience working in fraud investigation while enrolled in college.
According to the National Health Care Anti-Fraud Association, an investigator must have a certificate to practice in the field. The Accredited Health Care Fraud Investigator examination is a professional level test offered by Professional Testing Corporation. You can apply to take the test at a computer testing center in your city. The test looks at how well you respond to questions regarding the experiences you might have in the fraud industry. It also asks questions in relation to the ethics of working as an investigator and the laws put in place by the federal government. You’ll usually know within a few weeks how well you performed on the test and if you will receive your certificate.
Where Investigators Work
Most investigators tend to work in the health care industry. They work for independent doctors who own and operate their own practices, but they also work for larger hospitals that have hundreds of doctors on staff. Some investigation experts work on a freelance basis and agree to handle cases for doctors working in the local community or throughout the state. Investigators can also work for the insurance companies that offer medical malpractice insurance. There is also some need for trained investigators at the state and federal government levels.
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Investigators ensure that a case has merit before that case finds its way to the courtroom. They investigate the claims of victims and compare those claims to the facts of the case. A fraud investigator can work on a freelance basis, for a level of the government, in companies that specialize in investigation and for independent doctors.