What does a fraud investigator do?
A fraud investigator specializes in investigating and identifying fraudulent activities within a company and its clients. Their responsibilities depend on their line of work or industry of employment. However, most of the time, their duties will revolve around devising strategies and systems to detect inconsistencies, monitoring suspicious transactions and accounts, conducting reviews to identify any security lapses or vulnerabilities in the procedures, and teaching staff how to notice any fraudulent activities. Furthermore, it is vital to implement the policies and regulations of the company.
Fraud investigator responsibilities
Here are examples of responsibilities from real fraud investigator resumes:
- Manage corporate-wide document production relative to complex litigation cases.
- Detect and investigate fraudulent transactions such as money laundering, check forgeries, unauthorize ACH transfers and debit card fraud.
- Review ISO reports and maintain close contact with police agencies working on fraud investigations.
- Pursue recovery of bank funds through ACH processes, restitution from perpetrator and customer through criminal and civil means.
- Write suspicious activity reports, address fraud alerts, and other applicable AML processes in accordance with regulations and time limitations.
- Work on the development of a client application site determining the AML decision making rules, alerts, validation and verification.
- Review claims through establish affiliated contractor and CMS databases.
- Monitor regulatory compliance and program payment integrity updates from CMS.
- Research and order documentation from bank files for investigations and subpoenas.
- Research and investigate accounts with fraudulent activity and respond to court subpoenas.
- Participate in management level strategy meetings, SAR reporting, process improvements and overall trend analysis.
- Assist with examinations under oath, declaratory judgment actions, examinations before trial, and interrogatories.
- Assist SAR filing determinations by providing initial research, investigation, and analysis of suspicious customers and activity.
- Review information contain in claims billing to determine potential fraud or abusive billing or to detect vulnerabilities in Medicaid policies.
- Investigate complaints receive anonymously to determine whether individuals receiving TennCare benefits are entitled to those benefits or are committing Medicaid fraud.
Fraud investigator skills and personality traits
We calculated that 7% of Fraud Investigators are proficient in Law Enforcement Agencies, Investigative Reports, and Fraud Investigations. They’re also known for soft skills such as Detail oriented, Physical strength, and Communication skills.
We break down the percentage of Fraud Investigators that have these skills listed on their resume here:
- Law Enforcement Agencies, 7%
Prepared comprehensive investigative reports and other written communications for upper management, attorneys, prosecutors, and internal/external law enforcement agencies.
- Investigative Reports, 6%
Initiated and maintained law enforcement contacts, prepared detailed investigative reports which resulted in criminal prosecution and conviction.
- Fraud Investigations, 6%
Shared information with other Medicare contractors, law enforcement and other applicable stakeholders reference current fraud investigations and possible fraud patterns.
- Criminal Justice, 6%
Applied knowledge of the criminal justice court system, compliance regulations and collection procedures when researching a case for mortgage fraud.
- Financial Institutions, 4%
Developed and maintain comprehensive fraud database for reporting to financial institutions contracted with Early Warning Services.
- Fraud Claims, 4%
Boosted business savings by verifying identity theft/fraud claims, along with preventing fraudulent activities against business.
"law enforcement agencies," "investigative reports," and "fraud investigations" are among the most common skills that fraud investigators use at work. You can find even more fraud investigator responsibilities below, including:
Detail oriented. The most essential soft skill for a fraud investigator to carry out their responsibilities is detail oriented. This skill is important for the role because "fire inspectors must notice minutiae when inspecting sites for code violations or fire risks or for investigating the cause of a fire." Additionally, a fraud investigator resume shows how their duties depend on detail oriented: "performed detailed research of claims data related to medicare fraud. "
Physical strength. Many fraud investigator duties rely on physical strength. "fire investigators may have to move debris at the site of a fire in order to get a more accurate understanding of the scene.," so a fraud investigator will need this skill often in their role. This resume example is just one of many ways fraud investigator responsibilities rely on physical strength: "strengthened skills in fraud prevention for several companies as well as recognition of fraud in 30 different companies. "
Communication skills. fraud investigators are also known for communication skills, which are critical to their duties. You can see how this skill relates to fraud investigator responsibilities, because "fire inspectors must clearly explain fire code violations to building and property managers." A fraud investigator resume example shows how communication skills is used in the workplace: "handled inbound and outbound calls regarding identity theft for a telecommunications company. "
The three companies that hire the most fraud investigators are:
- Zurich13 fraud investigators jobs
- MetLife4 fraud investigators jobs
- Bank of America3 fraud investigators jobs
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Compare different fraud investigators
Fraud investigator vs. Certified fraud examiner
A fraud specialist is responsible for tracking and monitoring illegal transactions on customers' financial accounts without the authorization of the account owner. Fraud specialists report any suspicious account movements and unusual transactions that may be risky to the financial institution and customers. They may suspend a flagged account temporarily until the investigation is complete, verifying all transaction details and keep all information confidential until further notice. A fraud specialist must have excellent communication and critical-thinking skills to identify and resolve financial cases immediately to prevent loss and reputational damage to the bank.
While similarities exist, there are also some differences between fraud investigators and certified fraud examiner. For instance, fraud investigator responsibilities require skills such as "law enforcement agencies," "investigative reports," "criminal justice," and "fraud claims." Whereas a certified fraud examiner is skilled in "litigation," "cfe," "financial statements," and "cpa." This is part of what separates the two careers.
On average, certified fraud examiners reach higher levels of education than fraud investigators. Certified fraud examiners are 12.9% more likely to earn a Master's Degree and 2.6% more likely to graduate with a Doctoral Degree.Fraud investigator vs. Fraud specialist
Fraud analysts are responsible for monitoring bank accounts, accounting paperwork, and financial transactions. They analyze the data to identify any fraudulent and suspicious activities within an organization. Their duties and responsibilities may vary depending on which industries they work in. These may include keeping the confidentiality of any collected information, resolving customers' problems, and maintaining fraud analysis models to enhance the effectiveness and efficiency of company systems. Fraud analysts are also expected to provide recommendations for anti-fraud processes and new software tools to improve fraud detection and prevention.
Each career also uses different skills, according to real fraud investigator resumes. While fraud investigator responsibilities can utilize skills like "law enforcement agencies," "investigative reports," "criminal justice," and "in-depth investigations," fraud specialists use skills like "phone calls," "good judgment," "quality customer service," and "law enforcement."
Fraud specialists earn a lower average salary than fraud investigators. But fraud specialists earn the highest pay in the finance industry, with an average salary of $44,419. Additionally, fraud investigators earn the highest salaries in the finance with average pay of $59,765 annually.In general, fraud specialists achieve similar levels of education than fraud investigators. They're 4.5% less likely to obtain a Master's Degree while being 2.6% less likely to earn a Doctoral Degree.Fraud investigator vs. Fraud examiner
The required skills of the two careers differ considerably. For example, fraud investigators are more likely to have skills like "investigative reports," "criminal justice," "financial institutions," and "fraud claims." But a fraud examiner is more likely to have skills like "fraud detection," "hr," "tax returns," and "financial statements."
When it comes to education, fraud examiners tend to earn higher degree levels compared to fraud investigators. In fact, they're 6.6% more likely to earn a Master's Degree, and 2.8% more likely to graduate with a Doctoral Degree.Fraud investigator vs. Fraud analyst
Types of fraud investigator
Updated January 8, 2025
